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Galli C, Mazzola G, Arosio M, Pellegrinelli L, Boldrini A, Guarneri D, Lombarda E, Farina C, Cereda D, Pariani E. Real-time investigation of an influenza A(H3N2) virus outbreak in a refugee community, November 2022. Public Health 2024; 230:157-162. [PMID: 38554473 DOI: 10.1016/j.puhe.2024.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 02/02/2024] [Accepted: 02/27/2024] [Indexed: 04/01/2024]
Abstract
OBJECTIVES To report epidemiological and virological results of an outbreak investigation of influenza-like illness (ILI) among refugees in Northern Italy. STUDY DESIGN Outbreak investigation of ILI cases observed among nearly 100 refugees in Northern Italy unvaccinated for influenza. METHODS An epidemiological investigation matched with a differential diagnosis was carried out for each sample collected from ILI cases to identify 10 viral pathogens (SARS-CoV-2, influenza virus type A and B, respiratory syncytial virus, metapneumovirus, parainfluenza viruses, rhinovirus, enterovirus, parechovirus, and adenovirus) by using specific real-time PCR assays according to the Centers for Disease Control and Prevention (CDC) protocols. In cases where the influenza virus type was identified, complete hemagglutinin (HA) gene sequencing and the related phylogenetic analysis were conducted. RESULTS The outbreak was caused by influenza A(H3N2): the attack rate was 83.3% in children aged 9-14 years, 84.6% in those aged 15-24 years, and 28.6% in adults ≥25 years. Phylogenetic analyses uncovered that A(H3N2) strains were closely related since they segregated in the same cluster, showing both a high mean nucleotide identity (100%), all belonging to the genetic sub-group 3C.2a1b.2a.2, as those mainly circulating into the general population in the same period. CONCLUSIONS The fact that influenza outbreak strains as well as the community strains were genetically related to the seasonal vaccine strain suggests that if an influenza prevention by vaccination strategy had been implemented, a lower attack rate of A(H3N2) and ILI cases might have been achieved.
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Affiliation(s)
- C Galli
- Department of Biomedical Sciences for Health, University of Milan, Italy
| | - G Mazzola
- Department of Hygiene and Health Prevention (HPA of Bergamo/ATS of Bergamo), Italy
| | - M Arosio
- Microbiology and Virology Laboratory, ASST Papa Giovanni XXIII, Bergamo, Italy; Biobank, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - L Pellegrinelli
- Department of Biomedical Sciences for Health, University of Milan, Italy
| | - A Boldrini
- Department of Hygiene and Health Prevention (HPA of Bergamo/ATS of Bergamo), Italy
| | - D Guarneri
- Microbiology and Virology Laboratory, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - E Lombarda
- Department of Hygiene and Health Prevention (HPA of Bergamo/ATS of Bergamo), Italy
| | - C Farina
- Microbiology and Virology Laboratory, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - D Cereda
- Directorate General for Health, Lombardy Region, Milan, Italy
| | - E Pariani
- Department of Biomedical Sciences for Health, University of Milan, Italy.
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Abdalkareem Jasim S, Thaeer Hammid A, Turgunpulatovich Daminov B, Kadhem Abid M, Lateef Al-Awsi GR, Afra A, Ekrami HA, Ameer Muhammed FA, Mohammadi MJ. Investigation ways of causes needle sticks injuries, risk factors affecting on health and ways to preventive. REVIEWS ON ENVIRONMENTAL HEALTH 2023; 38:629-636. [PMID: 35962992 DOI: 10.1515/reveh-2022-0069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 07/05/2022] [Indexed: 06/15/2023]
Abstract
Needle sticks injuries (NSIs) has caused many health concerns, including the widespread infection disease. Needle sticks injuries can have high threaten health human especially, all those who are in contact with health and medical centers. The purpose of this review study was the determination the effects of needle sticks injuries (NSIs) on health care worker and patents. In this a review study of literature studied conducted on international databases included Google Scholar, ISI/WOS (Web of Science), Springer, Scopus, Medline/PubMed. The literature signs a notable undesirable affect from potential needle sticks injuries related to ways to preventive and risks factors among patents and health care worker. The literature was shown needle stick injuries can cause with a variety of ways including needle recapping, non-standard safety boxes, thin gloves, and inadequate personal protective equipment. According to the result this study, needle stick injuries can transfer infectious disease (Human Immunodeficiency viruses [HIV], Hepatitis C virus [HCV]) and increase risk health on health care worker and patients. According to research related to the subject, the ways to prevent reduce needle sticks include personal protective equipment, holding retraining courses for medical staff in the direction to raise awareness can significantly reduce cases of needle sticks injuries. Further research using more sophisticated methodology is warranted.
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Affiliation(s)
- Saade Abdalkareem Jasim
- Medical Laboratory Techniques Department, Al-maarif University College, Al-anbar-Ramadi, Iraq
| | - Ali Thaeer Hammid
- Computer Engineering Techniques Department, Faculty of Information Technology, Imam Ja'afar Al-Sadiq University, Baghdad, Iraq
| | | | - Mohammed Kadhem Abid
- Department of Anesthesia, College of Health & medical Technology, Al-Ayen University, Thi-Qar, Iraq
| | | | - Arghavan Afra
- Department of Nursing, School of Nursing, Abadan University of Medical Sciences, Abadan, Iran
| | - Hafez Ajam Ekrami
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Mohammad Javad Mohammadi
- Department of Environmental Health Engineering, School of Public Health and Environmental Technology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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3
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Schumacher S, Salmanton-García J, Liekweg A, Rolfes M, Seidel D, Mellinghoff SC, Cornely OA. Increasing influenza vaccination coverage in healthcare workers: analysis of an intensified on-site vaccination campaign during the COVID-19 pandemic. Infection 2023; 51:1417-1429. [PMID: 36853494 PMCID: PMC9972307 DOI: 10.1007/s15010-023-02007-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 02/16/2023] [Indexed: 03/01/2023]
Abstract
PURPOSE Influenza infections have substantial impact on healthcare institutions. While vaccination is the most effective preventive measure against influenza infection, vaccination coverage in healthcare workers is low. The study investigates the impact of an intensified influenza vaccination campaign in a maximum-care hospital on influenza vaccination coverage in healthcare workers during the COVID-19 pandemic in 2020/21. METHODS Building on findings from our previously published review Schumacher et al. (Infection 49(3): 387, 2021), an intensified influenza vaccination campaign comprising a mobile vaccination team providing on-site vaccination and vaccination at a recurring central vaccination site in addition to promotional measures was performed and analysed regarding vaccination coverage. A survey querying vaccination motivation was performed. Campaign strategies and vaccination coverage of influenza seasons between 2017/18 and 2019/20 were analysed. RESULTS The influenza vaccination campaign 2020/21 led to a significant 2.4-fold increase yielding an overall vaccination coverage of 40% among healthcare workers. A significant increase in vaccination coverage was observed across all professional fields; especially among nurses, a 2.7-fold increase, reaching a vaccination coverage of 48%, was observed. The COVID-19 pandemic positively influenced vaccination decision in 72% of first time ever or first time in over ten years influenza vaccinees. Vaccination coverage during prior vaccination campaigns focusing on educational measures did not exceed 17%. CONCLUSION A mobile vaccination team providing on-site vaccination and vaccinations at a central vaccination site in addition to promotional measures can be implemented to increase influenza vaccination coverage in healthcare workers. Our concept can inform influenza and other vaccination campaigns for healthcare workers.
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Affiliation(s)
- Sofie Schumacher
- Department of Anaesthesiology and Intensive Care Medicine, St. Elisabeth Hospital, Cologne, Germany
- Faculty of Medicine and University Hospital Cologne, Institute of Translational Research (CECAD), Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Herderstr. 52, 50931, Cologne, Germany
- Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Jon Salmanton-García
- Faculty of Medicine and University Hospital Cologne, Institute of Translational Research (CECAD), Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Herderstr. 52, 50931, Cologne, Germany
- Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Andrea Liekweg
- Pharmacy Department, University Hospital Cologne, Cologne, Germany
| | - Muriel Rolfes
- Faculty of Medicine and University Hospital Cologne, Institute of Translational Research (CECAD), Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Herderstr. 52, 50931, Cologne, Germany
- Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Danila Seidel
- Faculty of Medicine and University Hospital Cologne, Institute of Translational Research (CECAD), Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Herderstr. 52, 50931, Cologne, Germany
- Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, Germany
| | - Sibylle C Mellinghoff
- Faculty of Medicine and University Hospital Cologne, Institute of Translational Research (CECAD), Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Herderstr. 52, 50931, Cologne, Germany
- Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Oliver A Cornely
- Faculty of Medicine and University Hospital Cologne, Institute of Translational Research (CECAD), Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Herderstr. 52, 50931, Cologne, Germany.
- Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, Germany.
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany.
- Faculty of Medicine and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Köln), University of Cologne, Cologne, Germany.
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Marinos G, Lamprinos D, Georgakopoulos P, Oikonomou E, Zoumpoulis G, Siasos G, Schizas D, Damaskos C, Garmpis N, Garmpi A, Patoulis G, Patsourakos F, Datseris I, Tsoukalos E, Anyfantis ID, Papagiannis D, Symvoulakis EK, Rachiotis G. Increased Influenza Vaccination Coverage among Members of the Athens Medical Association Amidst COVID-19 Pandemic. Vaccines (Basel) 2022; 10:797. [PMID: 35632553 PMCID: PMC9148125 DOI: 10.3390/vaccines10050797] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/06/2022] [Accepted: 05/09/2022] [Indexed: 01/08/2023] Open
Abstract
Healthcare workers are at high risk of influenza virus infection as well as of transmitting the infection to vulnerable patients who may be at high risk of severe illness. The aim of this cross-sectional study was to investigate the prevalence and related factors of influenza vaccination coverage (2020-2021flu season), among members of the Athens Medical Association in Greece. This survey employed secondary analysis data from a questionnaire-based dataset on COVID-19 vaccination coverage and associated factors from surveyed doctors, registered within the largest medical association in Greece. All members were invited to participate in the anonymous online questionnaire-based survey over the period of 25 February to 13 March 2021. Finally, 1993 physicians (60% males; 40% females) participated in the study. Influenza vaccination coverage was estimated at 76%. Logistic regression analysis demonstrated that older age (OR = 1.02; 95% C.I. = 1.01-1.03), history of COVID-19 vaccination (OR = 2.71; 95% C.I. = 2.07-3.56) and perception that vaccines in general are safe (OR = 16.49; 95% C.I. = 4.51-60.25) were found to be independently associated factors with the likelihood of influenza vaccination coverage. Public health authorities should maximize efforts and undertake additional actions in order to increase the percentage of physicians/health care workers (HCWs) being immunized against influenza. The current COVID-19 pandemic offers an opportunity to focus on tailored initiatives and interventions aiming to improve the influenza vaccination coverage of HCWs in a spirit of synergy and cooperation.
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Affiliation(s)
- Georgios Marinos
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Dimitrios Lamprinos
- Emergency Department, Laiko General Hospital, 11527 Athens, Greece; (D.L.); (P.G.); (G.Z.)
| | | | - Evangelos Oikonomou
- Third Department of Cardiology, Thoracic Diseases General Hospital Sotiria, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece; (E.O.); (G.S.)
- First Department of Cardiology, Hippokration General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Georgios Zoumpoulis
- Emergency Department, Laiko General Hospital, 11527 Athens, Greece; (D.L.); (P.G.); (G.Z.)
| | - Gerasimos Siasos
- Third Department of Cardiology, Thoracic Diseases General Hospital Sotiria, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece; (E.O.); (G.S.)
| | - Dimitrios Schizas
- First Department of Surgery, Laikon General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Christos Damaskos
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Nikolaos Garmpis
- Second Department of Propaedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Anna Garmpi
- First Department of Propaedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - George Patoulis
- Athens’s Medical Association, 11527 Athens, Greece; (G.P.); (F.P.); (I.D.); (E.T.)
| | - Fotios Patsourakos
- Athens’s Medical Association, 11527 Athens, Greece; (G.P.); (F.P.); (I.D.); (E.T.)
| | - Ioannis Datseris
- Athens’s Medical Association, 11527 Athens, Greece; (G.P.); (F.P.); (I.D.); (E.T.)
| | - Efstathios Tsoukalos
- Athens’s Medical Association, 11527 Athens, Greece; (G.P.); (F.P.); (I.D.); (E.T.)
| | - Ioannis D. Anyfantis
- European Agency for Safety and Health at Work (EU-OSHA), Prevention and Research Unit, 48003 Bilbao, Spain;
| | - Dimitrios Papagiannis
- Public Health & Vaccines Laboratory, Faculty of Nursing, School of Health Science, University of Thessaly, 41110 Larissa, Greece;
| | - Emmanouil K. Symvoulakis
- Clinic of Social and Family Medicine, Faculty of Medicine, University of Crete, 71500 Heraklion, Greece;
| | - Georgios Rachiotis
- Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Lariss, Greece;
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5
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Shang J, Harrison JM, Chastain AM, Stone PW, Perera UGE, Madigan EA, Pogorzelska-Maziarz M, Dick AW. Influenza vaccination of home health care staff and the impact on patient hospitalizations. Am J Infect Control 2022; 50:369-374. [PMID: 35369936 PMCID: PMC9052587 DOI: 10.1016/j.ajic.2021.12.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 12/29/2021] [Accepted: 12/30/2021] [Indexed: 11/01/2022]
Abstract
BACKGROUND Influenza is associated with significant morbidity and mortality for adults aged 65 years and older. Influenza vaccination of health care workers is recommended. There is limited evidence regarding influenza vaccinations among health care workers in the home health care (HHC) setting and their impact on HHC patient outcomes. METHODS A national survey of HHC agencies was conducted in 2018-2019 and linked with patient data from the Centers for Medicare and Medicaid Services. Adjusted logistic regression models were used to estimate the association between hospital transfers due to respiratory infection during a 60 day HHC episode and staff vaccination policies. RESULTS Only 26.2% of HHC agencies had staff vaccination requirements and 71.2% agencies had staff vaccination rates higher than 75%. Agency policies for staff influenza vaccination were associated with reduced hospital transfers due to respiratory infection among HHC patients. DISCUSSION Influenza vaccination rates among HHC staff were low during the 2017-2018 influenza season. Policymakers may consider vaccination mandates to improve health care worker vaccination rates and protect patient safety. CONCLUSIONS This study sheds light on the potential impact of COVID-19 vaccination among HHC workers on patient outcomes. COVID-19 vaccination mandates could prove to be a vital tool in the fight against COVID-19 variants and infection outbreaks.
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Aghdassi SJS, Schwab F, Peña Diaz LA, Brodzinski A, Fucini GB, Hansen S, Kohlmorgen B, Piening B, Schlosser B, Schneider S, Weikert B, Wiese-Posselt M, Wolff S, Behnke M, Gastmeier P, Geffers C. Risk factors for nosocomial SARS-CoV-2 infections in patients: results from a retrospective matched case-control study in a tertiary care university center. Antimicrob Resist Infect Control 2022; 11:9. [PMID: 35039089 PMCID: PMC8762437 DOI: 10.1186/s13756-022-01056-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 01/09/2022] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Factors contributing to the spread of SARS-CoV-2 outside the acute care hospital setting have been described in detail. However, data concerning risk factors for nosocomial SARS-CoV-2 infections in hospitalized patients remain scarce. To close this research gap and inform targeted measures for the prevention of nosocomial SARS-CoV-2 infections, we analyzed nosocomial SARS-CoV-2 cases in our hospital during a defined time period. METHODS Data on nosocomial SARS-CoV-2 infections in hospitalized patients that occurred between May 2020 and January 2021 at Charité university hospital in Berlin, Germany, were retrospectively gathered. A SARS-CoV-2 infection was considered nosocomial if the patient was admitted with a negative SARS-CoV-2 reverse transcription polymerase chain reaction test and subsequently tested positive on day five or later. As the incubation period of SARS-CoV-2 can be longer than five days, we defined a subgroup of "definite" nosocomial SARS-CoV-2 cases, with a negative test on admission and a positive test after day 10, for which we conducted a matched case-control study with a one to one ratio of cases and controls. We employed a multivariable logistic regression model to identify factors significantly increasing the likelihood of nosocomial SARS-CoV-2 infections. RESULTS A total of 170 patients with a nosocomial SARS-CoV-2 infection were identified. The majority of nosocomial SARS-CoV-2 patients (n = 157, 92%) had been treated at wards that reported an outbreak of nosocomial SARS-CoV-2 cases during their stay or up to 14 days later. For 76 patients with definite nosocomial SARS-CoV-2 infections, controls for the case-control study were matched. For this subgroup, the multivariable logistic regression analysis revealed documented contact to SARS-CoV-2 cases (odds ratio: 23.4 (95% confidence interval: 4.6-117.7)) and presence at a ward that experienced a SARS-CoV-2 outbreak (odds ratio: 15.9 (95% confidence interval: 2.5-100.8)) to be the principal risk factors for nosocomial SARS-CoV-2 infection. CONCLUSIONS With known contact to SARS-CoV-2 cases and outbreak association revealed as the primary risk factors, our findings confirm known causes of SARS-CoV-2 infections and demonstrate that these also apply to the acute care hospital setting. This underscores the importance of rapidly identifying exposed patients and taking adequate preventive measures.
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Affiliation(s)
- Seven Johannes Sam Aghdassi
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203, Berlin, Germany. .,Berlin Institute of Health at Charité - Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité Digital Clinician Scientist Program, Anna-Louisa-Karsch-Straße 2, 10178, Berlin, Germany.
| | - Frank Schwab
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203, Berlin, Germany
| | - Luis Alberto Peña Diaz
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203, Berlin, Germany
| | - Annika Brodzinski
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203, Berlin, Germany
| | - Giovanni-Battista Fucini
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203, Berlin, Germany
| | - Sonja Hansen
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203, Berlin, Germany
| | - Britta Kohlmorgen
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203, Berlin, Germany
| | - Brar Piening
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203, Berlin, Germany
| | - Beate Schlosser
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203, Berlin, Germany
| | - Sandra Schneider
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203, Berlin, Germany
| | - Beate Weikert
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203, Berlin, Germany
| | - Miriam Wiese-Posselt
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203, Berlin, Germany
| | - Sebastian Wolff
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203, Berlin, Germany
| | - Michael Behnke
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203, Berlin, Germany
| | - Petra Gastmeier
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203, Berlin, Germany
| | - Christine Geffers
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Hindenburgdamm 27, 12203, Berlin, Germany
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7
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PIYARAJ P, KITTIKRAISAK W, BUATHONG S, SINTHUWATTANAWIBOOL C, NIVESVIVAT T, YOOCHAROEN P, NUCHTEAN T, KLUNGTHONG C, LYMAN M, MOTT JA, CHOTTANAPUND S. Encounter patterns and worker absenteeism/presenteeism among healthcare providers in Thailand. CURRENT RESEARCH IN BEHAVIORAL SCIENCES 2022. [DOI: 10.1016/j.crbeha.2022.100067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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8
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Suksatan W, Jasim SA, Widjaja G, Jalil AT, Chupradit S, Ansari MJ, Mustafa YF, Hammoodi HA, Mohammadi MJ. Assessment effects and risk of nosocomial infection and needle sticks injuries among patents and health care worker. Toxicol Rep 2022; 9:284-292. [PMID: 35273903 PMCID: PMC8904184 DOI: 10.1016/j.toxrep.2022.02.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/23/2021] [Accepted: 02/25/2022] [Indexed: 12/20/2022] Open
Affiliation(s)
- Wanich Suksatan
- Faculty of Nursing, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Saade Abdalkareem Jasim
- Al-maarif University College, Medical Laboratory Techniques Department, Al-anbar-Ramadi, Iraq
| | - Gunawan Widjaja
- Senior Lecturer Faculty of Public Health Universitas Indonesia/ Faculty of Law Universitas Krisnadwipayana, Indonesia
- Corresponding authors.
| | - Abduladheem Turki Jalil
- Faculty of Biology and Ecology, Yanka Kupala State University of Grodno, 230023 Grodno, Belarus
- College of technical engineering, The Islamic University, Najaf, Iraq
- Department of Dentistry, Kut University College, Kut, Wasit 52001, Iraq
| | - Supat Chupradit
- Department of Occupational Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Mohammad Javed Ansari
- Department of Pharmaceutics, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-kharj, Saudi Arabia
| | - Yasser Fakri Mustafa
- Department of Pharmaceutical Chemistry, College of Pharmacy, University of Mosul, Mosul, Iraq
| | - Hayder A. Hammoodi
- Pharmaceutics Department, College of Pharmacy, Al-Ayen University, Thi-Qar, Iraq
| | - Mohammad Javad Mohammadi
- Department of Environmental Health Engineering, School of Public Health AND Environmental Technologies Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Corresponding authors.
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9
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Zhan Y, Chen X, Guan W, Guan W, Yang C, Pan S, Wong SS, Chen R, Ye F. Clinical impact of nosocomial infection with pandemic influenza A (H1N1) 2009 in a respiratory ward in Guangzhou. J Thorac Dis 2021; 13:5851-5862. [PMID: 34795934 PMCID: PMC8575854 DOI: 10.21037/jtd-21-897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 09/09/2021] [Indexed: 11/17/2022]
Abstract
Background Nosocomial outbreaks of pandemic influenza A (H1N1) 2009 virus [A(H1N1)pdm09] easily develop due to its high transmissibility. This study aimed to investigate the clinical impacts of a nosocomial outbreak of A(H1N1)pdm09 between 21 January and 17 February 2016. Methods Patients who developed influenza-like illness (ILI) more than 48 hours after hospitalization in the index ward were enrolled as suspected patients, defined as group A and quarantined. Patients in other wards were defined as group B. A phylogenetic tree was constructed to determine the origins of the hemagglutinin and neuraminidase genes. Results After the implementation of an infection control measure bundle, the outbreak was limited to eight patients with ILIs in group A. Nasal swabs from seven patients were positive for A(H1N1)pdm09. All the patients recovered after treatment. Prolonged viral shedding was observed in a patient with bronchiectasis and Penicillium marneffei infection. Compared to the expected duration of hospitalization in patients without fever, those with fever had a median 7-day delay in discharge and a mean excess cost of 3,358 RMB. The four influenza strains identified were genetically identical to the A/California/115/2015 strain. Six of the 54 patients in group B who underwent bronchoscopy developed transient fever. These patients were hospitalized in various wards of the hospital and recovered after a short-term course of empirical antibiotics. Conclusions After the implementation of infection control measures, the nosocomial A(H1N1)pdm09 outbreak was rapidly contained; infected patients had a delay in discharge and excess costs, but no deaths occurred.
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Affiliation(s)
- Yangqing Zhan
- The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Xiaojuan Chen
- The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Weijie Guan
- The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Wenda Guan
- The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Chunguang Yang
- The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Sihua Pan
- The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Sook-San Wong
- The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Rongchang Chen
- The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China.,Department of Pulmonary and Critical Care Medicine, First Affiliated Hospital of Southern University of Science and Technology, Second Clinical Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen Institute of Respiratory Diseases, Shenzhen, China
| | - Feng Ye
- The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China
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10
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Hospital-acquired influenza in the United States, FluSurv-NET, 2011-2012 through 2018-2019. Infect Control Hosp Epidemiol 2021; 43:1447-1453. [PMID: 34607624 DOI: 10.1017/ice.2021.392] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To estimate population-based rates and to describe clinical characteristics of hospital-acquired (HA) influenza. DESIGN Cross-sectional study. SETTING US Influenza Hospitalization Surveillance Network (FluSurv-NET) during 2011-2012 through 2018-2019 seasons. METHODS Patients were identified through provider-initiated or facility-based testing. HA influenza was defined as a positive influenza test date and respiratory symptom onset >3 days after admission. Patients with positive test date >3 days after admission but missing respiratory symptom onset date were classified as possible HA influenza. RESULTS Among 94,158 influenza-associated hospitalizations, 353 (0.4%) had HA influenza. The overall adjusted rate of HA influenza was 0.4 per 100,000 persons. Among HA influenza cases, 50.7% were 65 years of age or older, and 52.0% of children and 95.7% of adults had underlying conditions; 44.9% overall had received influenza vaccine prior to hospitalization. Overall, 34.5% of HA cases received ICU care during hospitalization, 19.8% required mechanical ventilation, and 6.7% died. After including possible HA cases, prevalence among all influenza-associated hospitalizations increased to 1.3% and the adjusted rate increased to 1.5 per 100,000 persons. CONCLUSIONS Over 8 seasons, rates of HA influenza were low but were likely underestimated because testing was not systematic. A high proportion of patients with HA influenza were unvaccinated and had severe outcomes. Annual influenza vaccination and implementation of robust hospital infection control measures may help to prevent HA influenza and its impacts on patient outcomes and the healthcare system.
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11
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Alame M, Kaddoura M, Kharroubi S, Ezzeddine F, Hassan G, Diab El-Harakeh M, Al Ariqi L, Abubaker A, Zaraket H. Uptake rates, knowledge, attitudes, and practices toward seasonal influenza vaccination among healthcare workers in Lebanon. Hum Vaccin Immunother 2021; 17:4623-4631. [PMID: 34292126 DOI: 10.1080/21645515.2021.1948783] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Despite recommendations and their occupational risk to influenza infection vaccine hesitancy remains a challenge among healthcare workers (HCWs). No studies have been conducted in Lebanon to assess the influenza vaccine's acceptance among HCWs. We conducted a survey to assess factors associated with vaccine uptake and practices among HCWs in Lebanon. Only 40.4% of the HCWs reported receiving the 2018-2019 seasonal vaccine and 1 out 5 routinely received the seasonal vaccine. One-third of the HCWs reported having free access to the influenza vaccine. The willingness to receive the vaccine decreased had it been offered for a fee. Self, family and community protection (55.5%) was a key vaccination enabler. While, viral evolution, concerns regarding vaccine efficacy and side effects, and cost of vaccine ranked as top vaccination barriers. The majority of the HCWs (75%) recommended the vaccine to their patients. Past influenza vaccination (Odds ratio (OR) = 2.37, CI 1.48,3.79), willingness to receive the vaccine for free (OR = 6.93, CI 4.27-11.34) or having diagnosed influenza (OR = 1.81, CI 1.12-2.92) were significantly associated with HCWs' willingness to recommend the vaccine to patients. Better knowledge about influenza and vaccination was strongly associated with the willingness to receive and recommend the vaccine (p < .001). The vaccination rate among HCWs in Lebanon was suboptimal despite the positive attitudes toward the influenza vaccine. Interventions that enhance vaccine accessibility and knowledge are warranted to improve vaccination coverage among HCWs.
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Affiliation(s)
- Malak Alame
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Malak Kaddoura
- Department of Experimental Pathology, Immunology & Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.,Center for Infectious Diseases Research, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
| | - Samer Kharroubi
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Fatima Ezzeddine
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Ghadir Hassan
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Marwa Diab El-Harakeh
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Lubna Al Ariqi
- Infectious Hazards Management Unit, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Abdinasir Abubaker
- Infectious Hazards Management Unit, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Hassan Zaraket
- Department of Experimental Pathology, Immunology & Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.,Center for Infectious Diseases Research, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
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12
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Bénet T, Amour S, Valette M, Saadatian-Elahi M, Aho-Glélé LS, Berthelot P, Denis MA, Grando J, Landelle C, Astruc K, Paris A, Pillet S, Lina B, Vanhems P. Incidence of Asymptomatic and Symptomatic Influenza Among Healthcare Workers: A Multicenter Prospective Cohort Study. Clin Infect Dis 2021; 72:e311-e318. [PMID: 32750120 DOI: 10.1093/cid/ciaa1109] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 08/03/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Influenza is an important cause of viral hospital-acquired infection involving patients, healthcare workers (HCW), and visitors. The frequency of asymptomatic influenza among HCW with possible subsequent transmission is poorly described. The objective is to determine the cumulative incidence of asymptomatic, paucisymptomatic, and symptomatic influenza among HCW. METHOD A multicenter prospective cohort study was done in 5 French university hospitals, including 289 HCW during the 2016-2017 influenza season. HCW had 3 physical examinations (time [T] 0, before epidemic onset; T.1, before epidemic peak; T.2, T.3, after epidemic peak). A blood sample was taken each time for influenza serology and a nasal swab was collected at T1 and T2 for influenza detection by polymerase chain reaction (PCR). Positive influenza was defined as either a positive influenza PCR, and/or virus-specific seroconversion against influenza A, the only circulating virus, with no vaccination record during follow-up. Symptoms were self-reported daily between T1 and T2. Cumulative incidence of influenza was stratified by clinical presentation per 100 HCW. RESULTS Of the 289 HCW included, 278 (96%) completed the entire follow-up. Overall, 62 HCW had evidence of influenza of whom 46.8% were asymptomatic, 41.9% were paucisymptomatic, and 11.3% were symptomatic. Cumulative influenza incidence was 22.3% (95% confidence interval [CI]: 17.4%-27.2%). Cumulative incidence of asymptomatic influenza was 5.8% (95% CI: 3.3%-9.2%), 13.7% (95% CI: 9.9%-18.2%) for paucisymptomatic influenza, and 2.9% (95% CI: 1.3%-5.5%) for symptomatic influenza. CONCLUSIONS Asymptomatic and paucisymptomatic influenza were frequent among HCW, representing 47% and 42% of the influenza burden, respectively. These findings highlight the importance of systematic implementation of infection control measures among HCW regardless of respiratory symptoms from preventing nosocomial transmission of influenza. CLINICAL TRIALS REGISTRATION NCT02868658.
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Affiliation(s)
- Thomas Bénet
- Service d'Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France.,Équipe Épidémiologie et Santé Internationale, Laboratoire des Pathogènes Émergents, Fondation Mérieux, Centre International de Recherche en Infectiologie, Institut National de la Santé et de la Recherche Médicale U1111, Centre National de la Recherche Scientifique Unité Mixte de Recherche 5308, École Nationale Supérieure de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Sélilah Amour
- Service d'Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France
| | - Martine Valette
- Centre National de Référence des Infections Respiratoires, Région Sud.,Laboratoire de Virologie, Hôpital de la Croix-Rousse, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France
| | - Mitra Saadatian-Elahi
- Service d'Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France
| | | | - Philippe Berthelot
- Unité de Gestion du Risque Infectieux, Service d'Infectiologie, CHU de Saint-Etienne, Saint-Etienne, France.,Laboratoire des Agents Infectieux et Hygiène, CHU de Saint-Etienne, Saint-Etienne, France
| | - Marie-Agnès Denis
- Service de médecine et santé au travail, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France.,Ifsttar, UMRESTTE, UMR T_9405 Univ Lyon, Université Claude Bernard Lyon1, Lyon, France
| | - Jacqueline Grando
- Service d'Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France
| | - Caroline Landelle
- Service d'hygiène hospitalière, CHU Grenoble Alpes, Grenoble, France.,Université Grenoble Alpes, CNRS, Grenoble INP, TIMC-IMAG, Grenoble, France
| | - Karine Astruc
- Service d'Epidémiologie et d'Hygiène Hospitalière, CHU de Dijon, Dijon, France
| | - Adeline Paris
- Centre d'Investigation Clinique, Inserm CIC1406, CHU de Grenoble Alpes, Grenoble, France
| | - Sylvie Pillet
- Laboratoire des Agents Infectieux et Hygiène, CHU de Saint-Etienne, Saint-Etienne, France
| | - Bruno Lina
- Centre National de Référence des Infections Respiratoires, Région Sud.,Laboratoire de Virologie, Hôpital de la Croix-Rousse, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France.,Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Lyon center, France
| | - Philippe Vanhems
- Service d'Hygiène, Epidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, Lyon, France.,Équipe Épidémiologie et Santé Internationale, Laboratoire des Pathogènes Émergents, Fondation Mérieux, Centre International de Recherche en Infectiologie, Institut National de la Santé et de la Recherche Médicale U1111, Centre National de la Recherche Scientifique Unité Mixte de Recherche 5308, École Nationale Supérieure de Lyon, Université Claude Bernard Lyon 1, Lyon, France.,Inserm, F-CRIN, Réseau Innovative Clinical Research in Vaccinology (I-REIVAC), Lyon center, France
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13
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Impfungen von Personal in medizinischen Einrichtungen in Deutschland: Empfehlung zur Umsetzung der gesetzlichen Regelung in § 23a Infektionsschutzgesetz. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 64:636-642. [PMID: 33929567 PMCID: PMC8086965 DOI: 10.1007/s00103-021-03313-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
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14
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Hababou Y, Taleb A, Recoing A, Moreau F, Simon I, Muller de Schongor F, Gault E, Rameix-Welti MA. Molecular investigation of a RSV outbreak in a geriatric hospital. BMC Geriatr 2021; 21:120. [PMID: 33579210 PMCID: PMC7880219 DOI: 10.1186/s12877-021-02064-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 02/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Acquired infections in hospitalized elderly people are a growing concern. In long-term care facilities with multiple staff and visitor contacts, virus outbreaks are a common challenge for infection prevention teams. Although several studies have reported nosocomial RSV outbreaks in long term care facilities, molecular epidemiology data are scarce. METHODS RSV RNA was detected in respiratory samples from 19 patients in a long-term care hospital for elderly in Paris in March 2019 over a 3 weeks period. Genotyping was performed using nucleotide sequencing. Sociodemographic and clinical characteristics of cases part of a unique cluster, were retrospectively reviewed. RESULTS Molecular investigation of theses RSV cases, revealed a unique cluster of 12 nosocomial cases in 2 adjacent wards. Mean age of these outbreak's cases was 89. All patients had underlying medical conditions. Seven exhibited lower respiratory symptoms and three experienced decompensation of underlying chronic heart condition. Two patients died. CONCLUSIONS This case report highlights the importance of RSV in causing substantial disease in elderly in case of nosocomial outbreak and the contributions of molecular epidemiology in investigation and management of such outbreak.
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Affiliation(s)
- Yohan Hababou
- AP-HP, Université Paris Saclay, Hôpital Ambroise Paré, Laboratoire de Microbiologie, Boulogne-Billancourt, France
| | - Assia Taleb
- AP-HP, Université Paris Saclay, Hôpital Ambroise Paré, Laboratoire de Microbiologie, Boulogne-Billancourt, France
| | - Amélie Recoing
- AP-HP, Université Paris Saclay, Hôpital Ambroise Paré, Laboratoire de Microbiologie, Boulogne-Billancourt, France
| | - Frédérique Moreau
- AP-HP, Université Paris Saclay, Hôpital Ambroise Paré, Laboratoire de Microbiologie, Boulogne-Billancourt, France
| | - Isabelle Simon
- AP-HP, Université Paris Saclay, Hôpital Sainte Perrine, Equipe opérationnelle d'hygiène, Paris, France
| | | | - Elyanne Gault
- AP-HP, Université Paris Saclay, Hôpital Ambroise Paré, Laboratoire de Microbiologie, Boulogne-Billancourt, France.,Université Paris-Saclay, INSERM, Université de Versailles St. Quentin, UMR 1173 (2I), Versailles, France
| | - Marie-Anne Rameix-Welti
- AP-HP, Université Paris Saclay, Hôpital Ambroise Paré, Laboratoire de Microbiologie, Boulogne-Billancourt, France. .,Université Paris-Saclay, INSERM, Université de Versailles St. Quentin, UMR 1173 (2I), Versailles, France.
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15
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Qalla-Widmer L, Héquet D, Troillet N, Petignat C, Balmelli C, Bassi C, Bellini C, Chave JP, Cometta A, Christin L, Clerc O, Daher O, Fuehrer U, Marchetti O, Merz L, Portillo V, Pralong G, Sandoz L, Senn L, Tâche F, Iten A. Nosocomial influenza in south-western Swiss hospitals during two seasonal epidemics: an observational study. J Hosp Infect 2021; 109:115-122. [PMID: 33422590 DOI: 10.1016/j.jhin.2020.12.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 11/24/2020] [Accepted: 12/13/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND In Switzerland each year, influenza leads to between 112,000 and 275,000 medical consultations. Data on nosocomial influenza infection are limited. AIM To describe nosocomial cases of seasonal influenza in south-western Switzerland. METHODS This study was conducted during two seasonal influenza epidemics from 2016 to 2018 in 27 acute care public hospitals in south-western Switzerland. During these two time-periods, every patient hospitalized for >72 h who was positively screened by reverse transcription-polymerase chain reaction or antigen detection for influenza was included in the survey. Characteristics of patients included age, sex, and comorbidities. Included patients were followed up until discharge or death. Complications and administration of antineuraminidases and/or antibiotics were registered. FINDINGS The median influenza vaccine coverage of healthcare workers was 40%. In all, 836 patients were included (98% with type A influenza virus in 2016-2017; 77% with type B virus in 2017-2018). Most patients (81%) had an unknown vaccine status. Overall, the incidence of nosocomial influenza was 0.5 per 100 admissions (0.35 per 1000 patient-days). The most frequent comorbidities were diabetes (20%), chronic respiratory diseases (19%), and malnutrition (17%). Fever (77%) and cough (66%) were the most frequent symptoms. Seventy-one percent of patients received antineuraminidases, 28% received antibiotics. Infectious complications such as pneumonia were reported in 9%. Overall, the all-cause mortality was 6%. CONCLUSION The occurrence of nosocomial influenza underlines the importance of vaccinating patients and healthcare workers, rapidly recognizing community- or hospital-acquired cases, and applying adequate additional measures to prevent dissemination, including the timely administration of antineuraminidases to avoid antibiotic use (and misuse).
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Affiliation(s)
- L Qalla-Widmer
- Cantonal Unit for Infection Control and Prevention, Public Health Service, Lausanne, Switzerland
| | - D Héquet
- Cantonal Unit for Infection Control and Prevention, Public Health Service, Lausanne, Switzerland.
| | - N Troillet
- Service of Infectious Diseases, Central Institute, Valais Hospital, Sion, Switzerland
| | - C Petignat
- Cantonal Unit for Infection Control and Prevention, Public Health Service, Lausanne, Switzerland
| | - C Balmelli
- Servizio di Prevenzione delle Infezioni e Medicina del Personale, Ente Ospedaliero Cantonale, Ticino, Switzerland
| | - C Bassi
- Prevention and Control of Infection, Hôpital du Jura Bernois, Moutier, Saint-Imier, Switzerland
| | - C Bellini
- Hospitals and Clinics of the Canton of Vaud, Switzerland
| | - J-P Chave
- Hospitals and Clinics of the Canton of Vaud, Switzerland
| | - A Cometta
- Hospitals and Clinics of the Canton of Vaud, Switzerland
| | - L Christin
- Hospitals and Clinics of the Canton of Vaud, Switzerland
| | - O Clerc
- Department of Internal Medicine and Infectious Diseases, Pourtalès Hospital, Neuchâtel, Switzerland
| | - O Daher
- Hospitals and Clinics of the Canton of Vaud, Switzerland
| | - U Fuehrer
- Department of Internal Medicine and Infectious Diseases, Hôpital de Bienne, Switzerland
| | - O Marchetti
- Hospitals and Clinics of the Canton of Vaud, Switzerland
| | - L Merz
- Hospitals and Clinics of the Canton of Vaud, Switzerland
| | - V Portillo
- Prevention and Control of Infection, Hôpital du Jura, Switzerland
| | - G Pralong
- Hospitals and Clinics of the Canton of Vaud, Switzerland
| | - L Sandoz
- Hospitals and Clinics of the Canton of Vaud, Switzerland
| | - L Senn
- Service of Hospital Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - F Tâche
- Hospitals and Clinics of the Canton of Vaud, Switzerland
| | - A Iten
- Infection Control Program, Geneva University Hospitals, Geneva, Switzerland
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16
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Yang K, Zhang N, Gao C, Qin H, Wang A, Song L. Risk factors for hospital-acquired influenza A and patient characteristics: a matched case-control study. BMC Infect Dis 2020; 20:863. [PMID: 33213361 PMCID: PMC7675395 DOI: 10.1186/s12879-020-05580-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 11/03/2020] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND While hospital-acquired influenza A results in an additional cost burden and considerable mortality in patients, its risk factors are unknown. We aimed to describe the characteristics of patients vulnerable to hospital-acquired influenza A and to identify its risk factors to assist clinicians control hospital-acquired infections and reduce the burden of treatment. METHODS A case-control study was conducted among hospitalized patients aged ≥18 years at a tertiary level teaching hospital during the 2018-2019 influenza A season. Patient data were retrieved from hospital-based electronic medical records. Hospital-acquired influenza A was defined as a case of influenza A diagnosed 7 days or more after admission, in a patient with no evidence of influenza A infection on admission. The controls without influenza A were selected among patients exposed to the same setting and time period. We identified risk factors using conditional logistic regression and described the characteristics of hospital-acquired influenza A by comparing the clinical data of infected patients and the controls. RESULTS Of the 412 hospitalized patients with influenza A from all the departments in the study hospital, 93 (22.6%) cases were classified as hospital-acquired. The most common comorbidities of the 93 cases were hypertension (41.9%), coronary heart disease (21.5%), and cerebrovascular disease (20.4%). Before the onset of hospital-acquired influenza A, patients presented more lymphocytopenia (51.6% vs 35.5%, P = 0.027), hypoalbuminemia (78.5% vs 57.0%, P = 0.002), and pleural effusion (26.9% vs 9.7%, P = 0.002) than the matched controls. Infected patients also had longer hospital stays (18 days vs 14 days, P = 0.002), and higher mortality rates (10.8% vs 2.2%, P = 0.017) than the matched controls. Lymphocytopenia (odds ratio [OR]: 3.11; 95% confidence interval [CI]: 1.24-7.80; P = 0.016), hypoalbuminemia (OR: 2.24; 95% CI: 1.10-4.57; P = 0.027), and pleural effusion (OR: 3.09; 95% CI: 1.26-7.58; P = 0.014) were independently associated with hospital-acquired influenza A. CONCLUSIONS Lymphocytopenia, hypoalbuminemia and pleural effusion are independent risk factors that can help identify patients at high risk of hospital-acquired influenza A, which can extend hospital stay and is associated with a high mortality.
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Affiliation(s)
- Kui Yang
- Department of Pulmonary and Critical Care Medicine, Xijing Hospital, Fourth Military Medical University, No.127, Changle West Road, Xincheng District, Xi'an, 710032, Shaanxi Province, China
| | - Ni Zhang
- Department of Basic Medicine, Xi'an Medical University, No.1, Xin-Wang Road, Weiyang District, Xi'an, 710021, Shaanxi Province, China
| | - Chunchen Gao
- Department of Medical Genetics and Developmental Biology, Fourth Military Medical University, No.169, Changle West Road, Xincheng District, Xi'an, 710032, Shaanxi Province, China
| | - Hongyan Qin
- Department of Medical Genetics and Developmental Biology, Fourth Military Medical University, No.169, Changle West Road, Xincheng District, Xi'an, 710032, Shaanxi Province, China
| | - Anhui Wang
- Department of Epidemiology, School of Preventive Medicine, Fourth Military Medical University, No.169, Changle West Road, Xincheng District, Xi'an, 710032, Shaanxi Province, China
| | - Liqiang Song
- Department of Pulmonary and Critical Care Medicine, Xijing Hospital, Fourth Military Medical University, No.127, Changle West Road, Xincheng District, Xi'an, 710032, Shaanxi Province, China.
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Neufeind J, Wenchel R, Boedeker B, Wicker S, Wichmann O. Monitoring influenza vaccination coverage and acceptance among health-care workers in German hospitals - results from three seasons. Hum Vaccin Immunother 2020; 17:664-672. [PMID: 33124954 DOI: 10.1080/21645515.2020.1801072] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Health-care workers are an important vaccination target group, they are more frequently exposed to infectious diseases and can contribute to nosocomial infections. We established a country-wide online monitoring system to estimate influenza vaccine uptake and its determinants among German hospital staff (OKaPII). The online questionnaire included items on vaccination behavior and reasons for and against influenza vaccination. After a pilot phase in 2016, a country-wide roll-out was performed in 2017. Questions on measles (2018) and hepatitis B (2019) vaccination status were added in subsequent years. In 2017, 2018 and 2019 in total 52, 125 and 171 hospitals with 5 808, 17 891 and 27 163 employees participated, respectively. Influenza vaccination coverage in season 2016/17 and 2017/18 was similar (39.5% and 39.3%) while it increased by 12% in 2018/19 (52.3%). Uptake was higher for physicians than for nurses. Self-protection was the most common reason for influenza vaccination. While physicians mainly identified constraints as reasons for being unvaccinated, nurses mainly referred to a lack of vaccine confidence. Of the hospital staff, 87.0% were vaccinated against measles, 6.3% claimed to be protected due to natural infection; 97.7% were vaccinated against hepatitis B. OKaPII shows that influenza vaccination coverage among German hospital staff is low. Occupational group-specific differences should be considered: physicians might benefit from easier access; information campaigns might increase nurses' vaccine confidence. OKaPII serves as a platform to monitor the uptake of influenza and other vaccines; it also contributes to a better understanding of vaccination behavior and planning of targeted interventions.
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Affiliation(s)
- Julia Neufeind
- Immunization Unit, Robert Koch Institute, Berlin, Germany.,Charité University Medicine Berlin, Berlin, Germany
| | - Ronja Wenchel
- Immunization Unit, Robert Koch Institute, Berlin, Germany
| | - Birte Boedeker
- Immunization Unit, Robert Koch Institute, Berlin, Germany
| | - Sabine Wicker
- Occupational Health Service, University Hospital Frankfurt, Frankfurt, Germany
| | - Ole Wichmann
- Immunization Unit, Robert Koch Institute, Berlin, Germany
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18
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Aman AT, Wibawa T, Kosasih H, Asdie RH, Safitri I, Intansari US, Mawarti Y, Sudarmono P, Arif M, Puspitasari D, Alisjahbana B, Parwati KTM, Gasem MH, Lokida D, Lukman N, Hartono TS, Mardian Y, Liang CJ, Siddiqui S, Karyana M, Lau CY. Etiologies of severe acute respiratory infection (SARI) and misdiagnosis of influenza in Indonesia, 2013-2016. Influenza Other Respir Viruses 2020; 15:34-44. [PMID: 32666619 PMCID: PMC7405185 DOI: 10.1111/irv.12781] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 03/02/2020] [Accepted: 06/18/2020] [Indexed: 12/12/2022] Open
Abstract
Background Severe acute respiratory infection (SARI) accounts for a large burden of illness in Indonesia. However, epidemiology of SARI in tertiary hospitals in Indonesia is unknown. This study sought to assess the burden, clinical characteristics, and etiologies of SARI and concordance of clinical diagnosis with confirmed etiology. Methods Data and samples were collected from subjects presenting with SARI as part of the acute febrile Illness requiring hospitalization study (AFIRE). In tertiary hospitals, clinical diagnosis was ascertained from chart review. Samples were analyzed to determine the “true” etiology of SARI at hospitals and Indonesia Research Partnership on Infectious Diseases (INA‐RESPOND) laboratory. Distribution and characteristics of SARI by true etiology and accuracy of clinical diagnosis were assessed. Results Four hundred and twenty of 1464 AFIRE subjects presented with SARI; etiology was identified in 242 (57.6%), including 121 (28.8%) viruses and bacteria associated with systemic infections, 70 (16.7%) respiratory bacteria and viruses other than influenza virus, and 51 (12.1%) influenza virus cases. None of these influenza patients were accurately diagnosed as having influenza during hospitalization. Conclusions Influenza was misdiagnosed among all patients presenting with SARI to Indonesian tertiary hospitals in the AFIRE study. Diagnostic approaches and empiric management should be guided by known epidemiology. Public health strategies to address the high burden of influenza should include broad implementation of SARI screening, vaccination programs, clinician education and awareness campaigns, improved diagnostic capacity, and support for effective point‐of‐care tests.
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Affiliation(s)
- Abu Tholib Aman
- Department of Microbiology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada / Dr. Sardjito Hospital, Yogyakarta, Indonesia.,Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Jakarta, Indonesia
| | - Tri Wibawa
- Department of Microbiology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada / Dr. Sardjito Hospital, Yogyakarta, Indonesia.,Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Jakarta, Indonesia
| | - Herman Kosasih
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Jakarta, Indonesia
| | - Rizka Humardewayanti Asdie
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Jakarta, Indonesia.,Department of Internal Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada / Dr. Sardjito Hospital, Yogyakarta, Indonesia
| | - Ida Safitri
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Jakarta, Indonesia.,Department of Pediatric, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada / Dr. Sardjito Hospital, Yogyakarta, Indonesia
| | - Umi Solekhah Intansari
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Jakarta, Indonesia.,Department of Clinical Pathology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada / Dr. Sardjito Hospital, Yogyakarta, Indonesia
| | - Yuli Mawarti
- Department of Microbiology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada / Dr. Sardjito Hospital, Yogyakarta, Indonesia.,Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Jakarta, Indonesia
| | - Pratiwi Sudarmono
- Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Mansyur Arif
- Faculty of Medicine, Universitas Hasanudin / Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia
| | - Dwiyanti Puspitasari
- Dr. Soetomo Academic General Hospital, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Bachti Alisjahbana
- Faculty of Medicine, Universitas Padjadjaran / Dr. Hasan Sadikin Hospital, Sumedang, Indonesia
| | | | | | - Dewi Lokida
- Tangerang District Hospital, Tangerang, Indonesia
| | - Nurhayati Lukman
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Jakarta, Indonesia
| | - Teguh Sarry Hartono
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Jakarta, Indonesia.,Sulianti Saroso Hospital, Jakarta, Indonesia
| | - Yan Mardian
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Jakarta, Indonesia
| | - C Jason Liang
- National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health, Bethesda, MD, USA
| | - Sophia Siddiqui
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Jakarta, Indonesia.,National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health, Bethesda, MD, USA
| | - Muhammad Karyana
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Jakarta, Indonesia.,National Institute of Health Research and Development (NIHRD), Ministry of Health, Jakarta, Indonesia
| | - Chuen-Yen Lau
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Jakarta, Indonesia.,National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health, Bethesda, MD, USA
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19
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Tartari E, Saris K, Kenters N, Marimuthu K, Widmer A, Collignon P, Cheng VCC, Wong SC, Gottlieb T, Tambyah PA, Perencevich E, Allegranzi B, Dramowski A, Edmond MB, Voss A. Not sick enough to worry? "Influenza-like" symptoms and work-related behavior among healthcare workers and other professionals: Results of a global survey. PLoS One 2020; 15:e0232168. [PMID: 32401751 PMCID: PMC7219706 DOI: 10.1371/journal.pone.0232168] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 04/09/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Healthcare workers (HCWs) and non-HCWs may contribute to the transmission of influenza-like illness (ILI) to colleagues and susceptible patients by working while sick (presenteeism). The present study aimed to explore the views and behavior of HCWs and non-HCWs towards the phenomenon of working while experiencing ILI. METHODS The study was a cross-sectional online survey conducted between October 2018 and January 2019 to explore sickness presenteeism and the behaviour of HCWs and non-HCWs when experiencing ILI. The survey questionnaire was distributed to the members and international networks of the International Society of Antimicrobial Chemotherapy (ISAC) Infection Prevention and Control (IPC) Working Group, as well as via social media platforms, including LinkedIn, Twitter and IPC Blog. RESULTS In total, 533 respondents from 49 countries participated (Europe 69.2%, Asia-Pacific 19.1%, the Americas 10.9%, and Africa 0.8%) representing 249 HCWs (46.7%) and 284 non-HCWs (53.2%). Overall, 312 (58.5%; 95% confidence interval [CI], 56.2-64.6) would continue to work when sick with ILI, with no variation between the two categories. Sixty-seven (26.9%) HCWs and forty-six (16.2%) non-HCWs would work with fever alone (p<0 .01) Most HCWs (89.2-99.2%) and non-HCWs (80%-96.5%) would work with "minor" ILI symptoms, such as sore throat, sinus cold, fatigue, sneezing, runny nose, mild cough and reduced appetite. CONCLUSION A future strategy to successfully prevent the transmission of ILI in healthcare settings should address sick-leave policy management, in addition to encouraging the uptake of influenza vaccine.
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Affiliation(s)
- Ermira Tartari
- Infection Control Programme and WHO Collaborating Centre on Patient Safety, Geneva University Hospitals and University of Geneva Faculty of Medicine, Geneva, Switzerland
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Faculty of Health Sciences, University of Malta, Msida, Malta
| | - Katja Saris
- Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital (CWZ), Nijmegen, The Netherlands
- Department of Medical Microbiology, Radboudumc, Nijmegen, The Netherlands
- REshape Center for Innovation, Radboudumc, Nijmegen, The Netherlands
| | - Nikki Kenters
- Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital (CWZ), Nijmegen, The Netherlands
| | - Kalisvar Marimuthu
- Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore
- National Centre for Infectious Diseases, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Andreas Widmer
- University of Basel Hospitals and Clinics, Basel, Switzerland
| | - Peter Collignon
- Medical School, The Australian National University, Canberra, ACT, Australia
| | - Vincent C. C. Cheng
- Department of Microbiology, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China
- Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hospital Authority, Hong Kong SAR, China
| | - Shuk C. Wong
- Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hospital Authority, Hong Kong SAR, China
| | - Thomas Gottlieb
- Department of Microbiology and Infectious Diseases Concord Repatriation General Hospital, Sydney, NSW, Australia
| | - Paul A. Tambyah
- Department of Medicine, National University of Singapore, Singapore, Singapore
| | - Eli Perencevich
- Divisions of General Internal Medicine and Infectious Diseases, University of Iowa Carver College of Medicine, Iowa City, IA, United States of Amrerica
| | - Benedetta Allegranzi
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization, Geneva, Switzerland
| | - Angela Dramowski
- Department of Paediatrics and Child Health, Division of Paediatric Infectious Diseases, Stellenbosch University, Cape Town, South Africa
| | - Michael B. Edmond
- University of Iowa Hospitals and Clinics, Iowa City, IA, United States of America
| | - Andreas Voss
- Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital (CWZ), Nijmegen, The Netherlands
- Department of Medical Microbiology, Radboudumc, Nijmegen, The Netherlands
- REshape Center for Innovation, Radboudumc, Nijmegen, The Netherlands
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20
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Peytremann A, Senn N, Mueller Y. Are healthcare workers more likely than the general population to consult in primary care for an influenza-like illness? Results from a case-control study. Influenza Other Respir Viruses 2020; 14:524-529. [PMID: 32374511 PMCID: PMC7431651 DOI: 10.1111/irv.12750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 04/14/2020] [Accepted: 04/16/2020] [Indexed: 11/29/2022] Open
Abstract
Background Healthcare workers are at increased risk of contracting influenza. However, existing studies do not differentiate professional categories or domains of the healthcare system that are most at risk. Methods This case‐control study compared proportions of patients with professional activity in the healthcare system between cases consulting their primary care physician for an influenza‐like illness (ILI) and controls from the general patient population of the same practices of the Swiss sentinel network. Influenza was confirmed by rRT‐PCR in a subset of practices. Analysis used a mixed logistic regression model, including age and sex as potential confounders. Results During the 2018/2019 influenza surveillance season, out of 4287 ILI cases and 28 561 controls reported in 168 practices, 235 (5.5%), respectively 872 (3.1%), were active in the healthcare system. After adjustment, being active in health care increased the odds of consulting for an ILI (OR 1.66, 95% CI 1.40‐1.97). The association was strongest for physicians and nursing aides. In terms of work setting, odds of consulting for ILI were increased for professionals of almost all healthcare settings except home‐based care. Conclusion Individuals active in the healthcare system were more likely to consult their primary care physician for an influenza‐like illness than for another reason, compared with individuals not active in the healthcare system. These results warrant further efforts to understand influenza transmission in the healthcare system at large.
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Affiliation(s)
- Arnaud Peytremann
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Nicolas Senn
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Yolanda Mueller
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
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21
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Song JR, Fu YW, Li P, Du T, Du XJ, Wang S. Protective Effect of Recombinant Proteins of Cronobacter Sakazakii During Pregnancy on the Offspring. Front Cell Infect Microbiol 2020; 10:15. [PMID: 32076598 PMCID: PMC7006456 DOI: 10.3389/fcimb.2020.00015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 01/13/2020] [Indexed: 01/14/2023] Open
Abstract
Cronobacter sakazakii is a food-borne pathogen carried in milk powder that can cause severe bacteremia, enterocolitis, and meningitis in newborns, which can lead to death of newborns. Preventing infection by this pathogen is significant to the health of newborns. Since infants and young children are the main target group of C. sakazakii, it is considered that maternal immunity can enhance the protection of newborns. Previous studies showed that two proteins of C. sakazakii (GroEL and OmpX) exhibited high expression levels and elicited strong immune reactions, suggesting their potential as vaccine candidates. In this study, GroEL and OmpX were recombinantly expressed in Escherichia coli and purified as immunogens to immunize pregnant rats. Three days after birth, the progeny were challenged with C. sakazakii to determine the protective effect of maternal immunity on the offspring. The results showed that immunization during pregnancy decreased bacterial load in the brain and blood, reduced brain and intestine damage, and significantly increased specific antibody titers in the offspring. Immunization with the recombinant proteins significantly increased cytokine levels in the serum of the progeny. The group whose mothers were immunized with OmpX produced more IL-4, while the group whose mothers were immunized with GroEL produced more IFN-γ, indicating that the immunogens enhanced the Th2 and Th1 responses, respectively. However, although the immune response was induced by both proteins, only the offspring of the pregnant rats immunized with OmpX or OmpX/GroEL mixture showed delayed death, possibly because immunization with OmpX led to a stronger humoral immune response in the offspring, suggesting that OmpX was a better vaccine candidate than GroEL. This study first reported that exposure to C. sakazakii proteins during pregnancy could improve the offspring's ability to resist infection caused by this pathogen.
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Affiliation(s)
- Jia-Rong Song
- State Key Laboratory of Food Nutrition and Safety, College of Food Science and Engineering, Tianjin University of Science and Technology, Tianjin, China
| | - Yan-Wen Fu
- State Key Laboratory of Food Nutrition and Safety, College of Food Science and Engineering, Tianjin University of Science and Technology, Tianjin, China
| | - Ping Li
- State Key Laboratory of Food Nutrition and Safety, College of Food Science and Engineering, Tianjin University of Science and Technology, Tianjin, China
| | - Ting Du
- State Key Laboratory of Food Nutrition and Safety, College of Food Science and Engineering, Tianjin University of Science and Technology, Tianjin, China
| | - Xin-Jun Du
- State Key Laboratory of Food Nutrition and Safety, College of Food Science and Engineering, Tianjin University of Science and Technology, Tianjin, China
| | - Shuo Wang
- State Key Laboratory of Food Nutrition and Safety, College of Food Science and Engineering, Tianjin University of Science and Technology, Tianjin, China.,Tianjin Key Laboratory of Food Science and Health, School of Medicine, Nankai University, Tianjin, China
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22
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Bischoff W, Petraglia M, McLouth C, Viviano J, Bischoff T, Palavecino E. Intermittent occurrence of health care-onset influenza cases in a tertiary care facility during the 2017-2018 flu season. Am J Infect Control 2020; 48:112-115. [PMID: 31358423 DOI: 10.1016/j.ajic.2019.06.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 06/17/2019] [Accepted: 06/17/2019] [Indexed: 11/30/2022]
Abstract
Health care-onset influenza (HOI) poses a major risk for hospitalized patients. During the 2017-2018 season, 37 HOI cases out of 382 inpatients (9.7%) with influenza were detected in a tertiary care hospital. HOI and community-onset influenza cases peaked simultaneously, and employee absenteeism was delayed by 1 month. A HOI to community-onset influenza case-comparison revealed associations with placement in rehabilitation, leukocytosis, health care-associated infections, and elevated mortality rates. Interventions should be selected based on the epidemiology of influenza occurrence.
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Affiliation(s)
- Werner Bischoff
- Department of Internal Medicine, Section on Infectious Diseases, Infection Prevention and Health System Epidemiology, Wake Forest Baptist Medical Center, Winston-Salem, NC.
| | - Mark Petraglia
- Infection Prevention and Health System Epidemiology, Wake Forest Baptist Medical Center, Winston-Salem, NC
| | - Christopher McLouth
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC
| | - James Viviano
- Infection Prevention and Health System Epidemiology, Wake Forest Baptist Medical Center, Winston-Salem, NC
| | - Tammy Bischoff
- Department of Internal Medicine, Section on Infectious Diseases, Infection Prevention and Health System Epidemiology, Wake Forest Baptist Medical Center, Winston-Salem, NC
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23
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Naudion P, Lepiller Q, Bouiller K. Risk factors and clinical characteristics of patients with nosocomial influenza A infection. J Med Virol 2019; 92:1047-1052. [PMID: 31825110 DOI: 10.1002/jmv.25652] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 12/05/2019] [Indexed: 12/25/2022]
Abstract
Influenza is a public health burden, responsible for more than half a million deaths worldwide each year and explosive outbreaks in-hospital care units. At present, little is known about clinical characteristics and outcomes with nosocomial influenza infection. To assess clinical characteristics and outcome between nosocomial and community-acquired (CA) influenza in a tertiary care hospital. A retrospective study of hospitalized patients in a French tertiary care hospital from 1st December 2016 to 28th February 2017 for flu-illness confirmed by reverse transcription PCR. Overall, 208 patients with laboratory-confirmed influenza were included; whose 49 nosocomial cases (23.6%). Patients with nosocomial influenza were significantly older (79.1 ± 15.5 vs 64.8 ± 31.1 years old; P = .003), with the more rapidly fatal disease (10.2% vs 1.3%; P = .0032). They had a less respiratory failure (8.2% vs 21.4%; P = .036) but had a longer length of hospitalization (47.3 vs 12.9 days; P < .001) than patients with CA influenza. During this influenza outbreak, 19 patients died (9.1%), none of them were vaccinated. Effective control of outbreaks in hospital facilities is challenging. Hospitalized patients are vulnerable to nosocomial Influenza infections that can increase the length of stay and be responsible for the death. Surveillance and early warning systems should be encouraged. Vaccination policies in conjunction with isolation measures and better hand hygiene could reduce virus spreading in hospitals.
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Affiliation(s)
- Pauline Naudion
- Department of internal medicine, University hospital, Besançon, France
| | | | - Kevin Bouiller
- Department of infectious diseases, University hospital, Besançon, France
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24
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Blackburn RM, Frampton D, Smith CM, Fragaszy EB, Watson SJ, Ferns RB, Binter Š, Coen PG, Grant P, Shallcross LJ, Kozlakidis Z, Pillay D, Kellam P, Hué S, Nastouli E, Hayward AC. Nosocomial transmission of influenza: A retrospective cross-sectional study using next generation sequencing at a hospital in England (2012-2014). Influenza Other Respir Viruses 2019; 13:556-563. [PMID: 31536169 PMCID: PMC6800305 DOI: 10.1111/irv.12679] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 08/21/2019] [Accepted: 08/25/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The extent of transmission of influenza in hospital settings is poorly understood. Next generation sequencing may improve this by providing information on the genetic relatedness of viral strains. OBJECTIVES We aimed to apply next generation sequencing to describe transmission in hospital and compare with methods based on routinely-collected data. METHODS All influenza samples taken through routine care from patients at University College London Hospitals NHS Foundation Trust (September 2012 to March 2014) were included. We conducted Illumina sequencing and identified genetic clusters. We compared nosocomial transmission estimates defined using classical methods (based on time from admission to sample) and genetic clustering. We identified pairs of cases with space-time links and assessed genetic relatedness. RESULTS We sequenced influenza sampled from 214 patients. There were 180 unique genetic strains, 16 (8.8%) of which seeded a new transmission chain. Nosocomial transmission was indicated for 32 (15.0%) cases using the classical definition and 34 (15.8%) based on genetic clustering. Of the 50 patients in a genetic cluster, 11 (22.0%) had known space-time links with other cases in the same cluster. Genetic distances between pairs of cases with space-time links were lower than for pairs without spatial links (P < .001). CONCLUSIONS Genetic data confirmed that nosocomial transmission contributes significantly to the hospital burden of influenza and elucidated transmission chains. Prospective next generation sequencing could support outbreak investigations and monitor the impact of infection and control measures.
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Affiliation(s)
| | | | | | - Ellen B. Fragaszy
- Institute of Health InformaticsUCLLondonUK
- Department of Infectious Disease EpidemiologyFaculty of Epidemiology and Population HealthLondon School of Hygiene and Tropical MedicineLondonUK
| | - Simon J. Watson
- Wellcome Trust Sanger InstituteWellcome Trust Genome CampusHinxtonUK
| | - R. Bridget Ferns
- Clinical Microbiology and VirologyUniversity College London Hospitals NHS Foundation TrustLondonUK
| | - Špela Binter
- Wellcome Trust Sanger InstituteWellcome Trust Genome CampusHinxtonUK
| | - Pietro G. Coen
- Infection Control DepartmentUniversity College London HospitalsNHS Foundation TrustLondonUK
| | - Paul Grant
- Clinical Microbiology and VirologyUniversity College London Hospitals NHS Foundation TrustLondonUK
| | | | - Zisis Kozlakidis
- Institute of Health InformaticsUCLLondonUK
- International Agency for Research on CancerWorld Health OrganizationLyonFrance
| | - Deenan Pillay
- Division of Infection and ImmunityUCLLondonUK
- Africa Health Research InstituteDurbanSouth Africa
| | - Paul Kellam
- Wellcome Trust Sanger InstituteWellcome Trust Genome CampusHinxtonUK
| | - Stéphane Hué
- Department of Infectious Disease EpidemiologyFaculty of Epidemiology and Population HealthLondon School of Hygiene and Tropical MedicineLondonUK
| | - Eleni Nastouli
- Clinical Microbiology and VirologyUniversity College London Hospitals NHS Foundation TrustLondonUK
- Department of Population, Policy and PracticeUCL Institute of Child HealthLondonUK
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25
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Vorsters A, Bonanni P, Maltezou HC, Yarwood J, Brewer NT, Bosch FX, Hanley S, Cameron R, Franco EL, Arbyn M, Muñoz N, Kojouharova M, Pattyn J, Baay M, Karafillakis E, Van Damme P. The role of healthcare providers in HPV vaccination programs - A meeting report. PAPILLOMAVIRUS RESEARCH 2019; 8:100183. [PMID: 31476478 DOI: 10.1016/j.pvr.2019.100183] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 08/27/2019] [Indexed: 10/26/2022]
Abstract
The Human Papillomavirus (HPV) Prevention and Control Board convened a meeting in Bucharest, Romania (May 2018), to discuss the role of healthcare providers (HCPs) in prevention programs, with a focus on HPV vaccination and cervical cancer screening. International and local experts discussed the role that HCPs can play to increase the uptake of HPV vaccine and screening. Experts recommended: 1) increasing HCP norms of getting vaccinated; 2) training providers to make effective recommendations; 3) making culturally appropriate materials available, in local languages; and 4) centralizing and coordinating education and information material, to direct both HCPs and the general public to the best material available.
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Affiliation(s)
- Alex Vorsters
- Centre for the Evaluation of Vaccination, University of Antwerp, Belgium.
| | - Paolo Bonanni
- University of Florence, Health Sciences, Florence, Italy
| | - Helena C Maltezou
- Department for Interventions in Healthcare Facilities, Hellenic Center for Disease Control and Prevention, Athens, Greece
| | - Joanne Yarwood
- Immunisation and Countermeasures Division, National Infection Service, Public Health England, London, UK
| | - Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States
| | - F Xavier Bosch
- Cancer Epidemiology Research Program, IDIBELL, Catalan Institute of Oncology, L'Hospitalet De Llobregat, Barcelona, Spain
| | - Sharon Hanley
- Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Ross Cameron
- NHS National Health Services Scotland, Health Protection Scotland, Glasgow, UK
| | | | - Marc Arbyn
- Unit of Cancer Epidemiology, Scientific Institute of Public Health, Brussels, Belgium
| | - Nubia Muñoz
- Emeritus Professor at the Cancer Institute of Colombia, Colombia
| | - Mira Kojouharova
- National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Jade Pattyn
- Centre for the Evaluation of Vaccination, University of Antwerp, Belgium
| | - Marc Baay
- P95, Epidemiology and Pharmacovigilance, Leuven, Belgium
| | - Emilie Karafillakis
- Vaccine Confidence Project, London School of Hygiene & Tropical Medicine, London, UK
| | - Pierre Van Damme
- Centre for the Evaluation of Vaccination, University of Antwerp, Belgium
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26
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Jenkin DC, Mahgoub H, Morales KF, Lambach P, Nguyen-Van-Tam JS. A rapid evidence appraisal of influenza vaccination in health workers: An important policy in an area of imperfect evidence. Vaccine X 2019; 2:100036. [PMID: 31384750 PMCID: PMC6668237 DOI: 10.1016/j.jvacx.2019.100036] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 07/04/2019] [Accepted: 07/05/2019] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION The World Health Organization recommends vaccination of health workers (HWs) against influenza, but low uptake is intransigent.We conducted a Rapid Evidence Appraisal on: the risk of influenza in HWs, transmission risk from HWs to patients, the benefit of HW vaccination, and strategies for improving uptake. We aimed to capture a 'whole-of-system' perspective to consider possible benefits for HWs, employers and patients. METHODS We executed a comprehensive search of the available literature published from 2006 to 2018 in the English language. We developed search terms for seven separate questions following the PICO framework (population, intervention, comparators, outcomes) and queried nine databases. RESULTS Of 3784 publications identified, 52 met inclusion criteria. Seven addressed HW influenza risk, of which four found increased risk; 15 addressed influenza vaccine benefit to HWs or their employers, of which 10 found benefit; 11 addressed influenza transmission from HWs to patients, of which 6 found evidence for transmission; 12 unique studies addressed whether vaccinating HWs produced patient benefit, of which 9 concluded benefits accrued. Regarding the number of HWs needed to vaccinate (NNV) to deliver patient benefit, NNV estimates ranged from 3 to 36,000 but were in significant disagreement. Fourteen studies provided insights on strategies to improve uptake; the strongest evidence was for mandatory vaccination. CONCLUSIONS The evidence on most questions related to influenza vaccination in HWs is mixed and often of low-quality. Substantial heterogeneity exists in terms of study designs and settings, making comparison between studies difficult. Notwithstanding these limitations, a majority of studies suggests that influenza vaccination benefit HWs and their employers; and HWs are implicated in transmission events. The effects of vaccinating HWs on patient morbidity and mortality may include reductions in all-cause mortality and influenza-like illness (ILI). Taken together, the evidence suggests that HW vaccination is an important policy for HWs themselves, their employers, and their patients.
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Key Words
- GAVI, the global alliance for vaccines and immunization
- HW, health workers
- Health worker
- Healthcare
- ILI, influenza like illness
- Influenza
- LTCF, long-term care facility(ies)
- NNV, number needed to vaccinate
- OR, odds ratio
- Policy
- RCTs, randomised controlled trials
- RR, relative risk
- Transmission
- Vaccine
- WHO, World Health organization
- cRCTs, clustered randomised controlled trials
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Affiliation(s)
- Dawn C. Jenkin
- Health Protection and Influenza Research Group (WHO Collaborating Centre), University of Nottingham School of Medicine, United Kingdom
| | - Hamid Mahgoub
- East of England Health Protection Team, Public Health England, United Kingdom
| | | | | | - Jonathan S. Nguyen-Van-Tam
- Health Protection and Influenza Research Group (WHO Collaborating Centre), University of Nottingham School of Medicine, United Kingdom
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Which healthcare workers work with acute respiratory illness? Evidence from Canadian acute-care hospitals during 4 influenza seasons: 2010-2011 to 2013-2014. Infect Control Hosp Epidemiol 2019; 40:889-896. [PMID: 31208477 DOI: 10.1017/ice.2019.141] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Healthcare workers (HCWs) are at risk of acquiring and transmitting respiratory viruses while working in healthcare settings. OBJECTIVES To investigate the incidence of and factors associated with HCWs working during an acute respiratory illness (ARI). METHODS HCWs from 9 Canadian hospitals were prospectively enrolled in active surveillance for ARI during the 2010-2011 to 2013-2014 influenza seasons. Daily illness diaries during ARI episodes collected information on symptoms and work attendance. RESULTS At least 1 ARI episode was reported by 50.4% of participants each study season. Overall, 94.6% of ill individuals reported working at least 1 day while symptomatic, resulting in an estimated 1.9 days of working while symptomatic and 0.5 days of absence during an ARI per participant season. In multivariable analysis, the adjusted relative risk of working while symptomatic was higher for physicians and lower for nurses relative to other HCWs. Participants were more likely to work if symptoms were less severe and on the illness onset date compared to subsequent days. The most cited reason for working while symptomatic was that symptoms were mild and the HCW felt well enough to work (67%). Participants were more likely to state that they could not afford to stay home if they did not have paid sick leave and were younger. CONCLUSIONS HCWs worked during most episodes of ARI, most often because their symptoms were mild. Further data are needed to understand how best to balance the costs and risks of absenteeism versus those associated with working while ill.
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Wilson KE, Wood SM, Schaecher KE, Cromwell KB, Godich J, Knapp MH, Sklar MJ, Ewing D, Raviprakash K, Defang G, Whitman TJ. Nosocomial outbreak of influenza A H3N2 in an inpatient oncology unit related to health care workers presenting to work while ill. Am J Infect Control 2019; 47:683-687. [PMID: 30616930 PMCID: PMC7115309 DOI: 10.1016/j.ajic.2018.10.024] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 10/31/2018] [Accepted: 10/31/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To describe an outbreak of influenza A in an oncology unit, highlighting infection control methods implemented, and examining reasons health care workers (HCWs) present to work with influenza-like illness (ILI). METHODS Confirmed cases were defined by the presence of ILI and a positive nasopharyngeal polymerase chain reaction swab for influenza A H3. Probable cases were defined as exposed HCWs with ILI who were unavailable for polymerase chain reaction testing. Infection prevention measures included closing the ward for new admissions, oseltamivir prophylaxis for all exposed groups, and dismissal from work of HCWs with ILI until resolution of symptoms. An anonymous survey of the cases in our HCWs was conducted to better elucidate reasons behind presenteeism. RESULTS Over the course of 8 days (November 16, 2017, to November 22, 2017), influenza was diagnosed in 7 of 10 inpatients on the oncology ward, 16 HCWs (14 confirmed, 2 probable), and 2 visitors. The suspected index case was an HCW. Of the surveyed HCWs, 64% presented to work despite feeling ill (ie, presenteeism). The most common reason was "sense of duty as a health care worker." CONCLUSIONS This nosocomial outbreak of influenza highlights the challenges of protecting inpatients from viral respiratory tract infections. HCWs and patient visitors with ILI should avoid work or visiting until resolution of peak respiratory symptoms and adhere to strict respiratory etiquette.
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Affiliation(s)
- Kerry E Wilson
- Infectious Diseases Service, Walter Reed National Military Medical Center, Bethesda, MD.
| | - Shannon M Wood
- Infectious Diseases Service, Walter Reed National Military Medical Center, Bethesda, MD
| | - Kurt E Schaecher
- Department of Microbiology, Walter Reed National Military Medical Center, Bethesda, MD
| | - Karen B Cromwell
- Infectious Diseases Service, Walter Reed National Military Medical Center, Bethesda, MD
| | - Joan Godich
- Infectious Diseases Service, Walter Reed National Military Medical Center, Bethesda, MD
| | - Melissa H Knapp
- Department of Emergency Management, Walter Reed National Military Medical Center, Bethesda, MD
| | - Marvin J Sklar
- Department of Viral and Rickettsial Diseases, Naval Medical Research Center, Silver Spring, MD
| | - Daniel Ewing
- Department of Viral and Rickettsial Diseases, Naval Medical Research Center, Silver Spring, MD
| | - Kanakatte Raviprakash
- Department of Viral and Rickettsial Diseases, Naval Medical Research Center, Silver Spring, MD
| | - Gabriel Defang
- Department of Viral and Rickettsial Diseases, Naval Medical Research Center, Silver Spring, MD
| | - Timothy J Whitman
- Infectious Diseases Service, Walter Reed National Military Medical Center, Bethesda, MD
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Wang R, Li Y, Si Y, Wang F, Liu Y, Ma Y, Yu J, Yin X, Ding B. Rechargeable polyamide-based N-halamine nanofibrous membranes for renewable, high-efficiency, and antibacterial respirators. NANOSCALE ADVANCES 2019; 1:1948-1956. [PMID: 36134243 PMCID: PMC9418896 DOI: 10.1039/c9na00103d] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 03/24/2019] [Indexed: 05/25/2023]
Abstract
Emerging infectious diseases (EIDs) have been acknowledged as a major public health concern worldwide. Unfortunately, most protective respirators used to prevent EID transmission suffer from the disadvantage of lacking antimicrobial activity, leading to an increased risk of cross-contamination and post-infection. Herein, we report a novel and facile strategy to fabricate rechargeable and biocidal air filtration materials by creating advanced N-halamine structures based on electrospun polyamide (PA) nanofibers. Our approach can endow the resultant nanofibrous membranes with powerful biocidal activity (6 log CFU reduction against E. coli), an ultrahigh fine particle capture efficiency of 99.999% (N100 level for masks), and can allow the antibacterial efficacy and air filtration performance to be renewed in a one-step chlorination process, which has never been reported before. More importantly, for the first time, we revealed the synergistic effect involving the intrinsic structure of polymers and the assembling structure of nanofibers on the chlorination capacity. The successful fabrication of such a fascinating membrane can provide new insights into the development of nanofibrous materials in a multifunctional, durable, and renewable form.
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Affiliation(s)
- Ru Wang
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, College of Textiles, Donghua University Shanghai 201620 China
| | - Yuyao Li
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, College of Textiles, Donghua University Shanghai 201620 China
| | - Yang Si
- Innovation Center for Textile Science and Technology, Donghua University Shanghai 200051 China
| | - Fei Wang
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, College of Textiles, Donghua University Shanghai 201620 China
| | - Yitao Liu
- Innovation Center for Textile Science and Technology, Donghua University Shanghai 200051 China
| | - Ying Ma
- Innovation Center for Textile Science and Technology, Donghua University Shanghai 200051 China
| | - Jianyong Yu
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, College of Textiles, Donghua University Shanghai 201620 China
- Innovation Center for Textile Science and Technology, Donghua University Shanghai 200051 China
| | - Xia Yin
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, College of Textiles, Donghua University Shanghai 201620 China
- Innovation Center for Textile Science and Technology, Donghua University Shanghai 200051 China
| | - Bin Ding
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, College of Textiles, Donghua University Shanghai 201620 China
- Innovation Center for Textile Science and Technology, Donghua University Shanghai 200051 China
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Uyeki TM, Bernstein HH, Bradley JS, Englund JA, File TM, Fry AM, Gravenstein S, Hayden FG, Harper SA, Hirshon JM, Ison MG, Johnston BL, Knight SL, McGeer A, Riley LE, Wolfe CR, Alexander PE, Pavia AT. Clinical Practice Guidelines by the Infectious Diseases Society of America: 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenzaa. Clin Infect Dis 2019; 68:e1-e47. [PMID: 30566567 PMCID: PMC6653685 DOI: 10.1093/cid/ciy866] [Citation(s) in RCA: 352] [Impact Index Per Article: 70.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 10/05/2018] [Indexed: 12/19/2022] Open
Abstract
These clinical practice guidelines are an update of the guidelines published by the Infectious Diseases Society of America (IDSA) in 2009, prior to the 2009 H1N1 influenza pandemic. This document addresses new information regarding diagnostic testing, treatment and chemoprophylaxis with antiviral medications, and issues related to institutional outbreak management for seasonal influenza. It is intended for use by primary care clinicians, obstetricians, emergency medicine providers, hospitalists, laboratorians, and infectious disease specialists, as well as other clinicians managing patients with suspected or laboratory-confirmed influenza. The guidelines consider the care of children and adults, including special populations such as pregnant and postpartum women and immunocompromised patients.
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Affiliation(s)
- Timothy M Uyeki
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Henry H Bernstein
- Division of General Pediatrics, Cohen Children's Medical Center, New Hyde Park, New York
| | - John S Bradley
- Division of Infectious Diseases, Rady Children's Hospital
- University of California, San Diego
| | - Janet A Englund
- Department of Pediatrics, University of Washington, Seattle Children's Hospital
| | - Thomas M File
- Division of Infectious Diseases Summa Health, Northeast Ohio Medical University, Rootstown
| | - Alicia M Fry
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Stefan Gravenstein
- Providence Veterans Affairs Medical Center and Center for Gerontology and Healthcare Research, Brown University, Providence, Rhode Island
| | - Frederick G Hayden
- Division of Infectious Diseases and International Health, University of Virginia Health System, Charlottesville
| | - Scott A Harper
- Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jon Mark Hirshon
- Department of Emergency Medicine, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore
| | - Michael G Ison
- Divisions of Infectious Diseases and Organ Transplantation, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - B Lynn Johnston
- Department of Medicine, Dalhousie University, Nova Scotia Health Authority, Halifax, Canada
| | - Shandra L Knight
- Library and Knowledge Services, National Jewish Health, Denver, Colorado
| | - Allison McGeer
- Division of Infection Prevention and Control, Sinai Health System, University of Toronto, Ontario, Canada
| | - Laura E Riley
- Department of Maternal-Fetal Medicine, Massachusetts General Hospital, Boston
| | - Cameron R Wolfe
- Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina
| | - Paul E Alexander
- McMaster University, Hamilton, Ontario, Canada
- Infectious Diseases Society of America, Arlington, Virginia
| | - Andrew T Pavia
- Division of Pediatric Infectious Diseases, University of Utah, Salt Lake City
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Uyeki TM, Bernstein HH, Bradley JS, Englund JA, File TM, Fry AM, Gravenstein S, Hayden FG, Harper SA, Hirshon JM, Ison MG, Johnston BL, Knight SL, McGeer A, Riley LE, Wolfe CR, Alexander PE, Pavia AT. Clinical Practice Guidelines by the Infectious Diseases Society of America: 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenzaa. Clin Infect Dis 2019; 68. [PMID: 30566567 PMCID: PMC6653685 DOI: 10.1093/cid/ciy866 10.1093/cid/ciz044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023] Open
Abstract
These clinical practice guidelines are an update of the guidelines published by the Infectious Diseases Society of America (IDSA) in 2009, prior to the 2009 H1N1 influenza pandemic. This document addresses new information regarding diagnostic testing, treatment and chemoprophylaxis with antiviral medications, and issues related to institutional outbreak management for seasonal influenza. It is intended for use by primary care clinicians, obstetricians, emergency medicine providers, hospitalists, laboratorians, and infectious disease specialists, as well as other clinicians managing patients with suspected or laboratory-confirmed influenza. The guidelines consider the care of children and adults, including special populations such as pregnant and postpartum women and immunocompromised patients.
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Affiliation(s)
- Timothy M Uyeki
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Henry H Bernstein
- Division of General Pediatrics, Cohen Children's Medical Center, New Hyde Park, New York
| | - John S Bradley
- Division of Infectious Diseases, Rady Children's Hospital
- University of California, San Diego
| | - Janet A Englund
- Department of Pediatrics, University of Washington, Seattle Children's Hospital
| | - Thomas M File
- Division of Infectious Diseases Summa Health, Northeast Ohio Medical University, Rootstown
| | - Alicia M Fry
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Stefan Gravenstein
- Providence Veterans Affairs Medical Center and Center for Gerontology and Healthcare Research, Brown University, Providence, Rhode Island
| | - Frederick G Hayden
- Division of Infectious Diseases and International Health, University of Virginia Health System, Charlottesville
| | - Scott A Harper
- Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jon Mark Hirshon
- Department of Emergency Medicine, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore
| | - Michael G Ison
- Divisions of Infectious Diseases and Organ Transplantation, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - B Lynn Johnston
- Department of Medicine, Dalhousie University, Nova Scotia Health Authority, Halifax, Canada
| | - Shandra L Knight
- Library and Knowledge Services, National Jewish Health, Denver, Colorado
| | - Allison McGeer
- Division of Infection Prevention and Control, Sinai Health System, University of Toronto, Ontario, Canada
| | - Laura E Riley
- Department of Maternal-Fetal Medicine, Massachusetts General Hospital, Boston
| | - Cameron R Wolfe
- Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina
| | - Paul E Alexander
- McMaster University, Hamilton, Ontario, Canada
- Infectious Diseases Society of America, Arlington, Virginia
| | - Andrew T Pavia
- Division of Pediatric Infectious Diseases, University of Utah, Salt Lake City
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Knowler P, Barrett M, Watson DAR. Attitudes of healthcare workers to influenza vaccination. Infect Dis Health 2018. [DOI: 10.1016/j.idh.2018.03.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Sansone M, Wiman Å, Karlberg ML, Brytting M, Bohlin L, Andersson LM, Westin J, Nordén R. Molecular characterization of a nosocomial outbreak of influenza B virus in an acute care hospital setting. J Hosp Infect 2018; 101:30-37. [PMID: 29909095 PMCID: PMC7114871 DOI: 10.1016/j.jhin.2018.06.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 06/04/2018] [Indexed: 01/21/2023]
Abstract
Aim To describe a hospital outbreak of influenza B virus (InfB) infection during season 2015/2016 by combining clinical and epidemiological data with molecular methods. Methods Twenty patients diagnosed with InfB from a hospital outbreak over a four-week-period were included. Nasopharyngeal samples (NPS) positive for InfB by multiplex real-time polymerase chain reaction were sent for lineage typing and whole genome sequencing (WGS). Medical records were reviewed retrospectively for data regarding patient characteristics, localization, exposure and outcome, and assembled into a timeline. In order to find possible connections to the hospital outbreak, all patients with a positive NPS for influenza from the region over an extended time period were also reviewed. Findings All 20 cases of InfB were of subtype B/Yamagata, and 17 of 20 patients could be linked to each other by either shared room or shared ward. WGS was successful or partially successful for 15 of the 17 viral isolates, and corroborated the epidemiological link supporting a close relationship. In the main affected ward, 19 of 75 inpatients were infected with InfB during the outbreak period, resulting in an attack rate of 25%. One probable case of influenza-related death was identified. Conclusion InfB may spread within an acute care hospital, and advanced molecular methods may facilitate assessment of the source and extent of the outbreak. A multi-faceted approach, including rapid diagnosis, early recognition of outbreak situations, simple rules for patient management and the use of regular infection control measures, may prevent nosocomial transmission of influenza virus.
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Affiliation(s)
- M Sansone
- Institute of Biomedicine, Department of Infectious Diseases, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Å Wiman
- Public Health Agency of Sweden, Solna, Sweden
| | | | - M Brytting
- Public Health Agency of Sweden, Solna, Sweden
| | - L Bohlin
- Department of Internal Medicine, Kungalv Hospital, Kungalv, Sweden
| | - L-M Andersson
- Institute of Biomedicine, Department of Infectious Diseases, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - J Westin
- Institute of Biomedicine, Department of Infectious Diseases, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - R Nordén
- Institute of Biomedicine, Department of Infectious Diseases, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Tomb RM, White TA, Coia JE, Anderson JG, MacGregor SJ, Maclean M. Review of the Comparative Susceptibility of Microbial Species to Photoinactivation Using 380-480 nm Violet-Blue Light. Photochem Photobiol 2018; 94:445-458. [DOI: 10.1111/php.12883] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 12/08/2017] [Indexed: 12/24/2022]
Affiliation(s)
- Rachael M. Tomb
- The Robertson Trust Laboratory for Electronic Sterilisation Technologies (ROLEST); Department of Electronic & Electrical Engineering; University of Strathclyde; Glasgow UK
| | - Tracy A. White
- The Robertson Trust Laboratory for Electronic Sterilisation Technologies (ROLEST); Department of Electronic & Electrical Engineering; University of Strathclyde; Glasgow UK
| | - John E. Coia
- Department of Clinical Microbiology; Glasgow Royal Infirmary; Glasgow UK
| | - John G. Anderson
- The Robertson Trust Laboratory for Electronic Sterilisation Technologies (ROLEST); Department of Electronic & Electrical Engineering; University of Strathclyde; Glasgow UK
| | - Scott J. MacGregor
- The Robertson Trust Laboratory for Electronic Sterilisation Technologies (ROLEST); Department of Electronic & Electrical Engineering; University of Strathclyde; Glasgow UK
| | - Michelle Maclean
- The Robertson Trust Laboratory for Electronic Sterilisation Technologies (ROLEST); Department of Electronic & Electrical Engineering; University of Strathclyde; Glasgow UK
- Department of Biomedical Engineering; University of Strathclyde; Glasgow UK
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Laris González A, Villa Guillén M, López Martínez B, Gamiño Arroyo AE, Moreno Espinosa S, Jiménez Juárez RN, Sánchez Huerta JL, de la Rosa Zamboni D. Influenza-like illness in healthcare personnel at a paediatric referral hospital: Clinical picture and impact of the disease. Influenza Other Respir Viruses 2018; 12:475-481. [PMID: 29505162 PMCID: PMC6005608 DOI: 10.1111/irv.12553] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2018] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Healthcare personnel (HP) are frequently exposed to influenza and can be a source of transmission to patients and other workers, resulting in high-cost outbreaks for healthcare institutions. OBJECTIVES To analyse the presentation of HP with influenza-like illness (ILI) and the differences between individuals with influenza confirmed by polymerase chain reaction (PCR) and those with a negative test. The secondary objective was to evaluate the duration of symptomatology and work absenteeism as well as the vaccination rate of HP at a paediatric referral hospital. METHODS A cross-sectional, descriptive study was conducted at a paediatric referral hospital. Clinical and epidemiological data on HP with ILI were collected between January and April 2016. Nasopharyngeal swab for influenza PCR was obtained from one in every three workers with ILI. Telephone follow-up was conducted to document duration of symptoms, complications and absenteeism. RESULTS A total of 164 ILI episodes were evaluated in 162 HP. A swab was obtained in 59 cases, and influenza was detected in 30 cases. The clinical picture of HP with confirmed influenza was similar to that of HP with a negative PCR. Arthralgia was more common in those with influenza (90% vs 58%), with a tendency towards statistical significance. No HP required hospitalization, and 78.5% were absent from work at least 1 day. CONCLUSIONS Influenza causes significant morbidity and absenteeism among HP. Influenza infection was confirmed in only half of HP with an ILI on whom a PCR was performed, suggesting that other respiratory viruses can cause a similar pattern.
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Abstract
PURPOSE OF REVIEW The prevalence and incidence of viral nosocomial influenza infections in healthcare settings are underestimated. Nosocomial influenza outbreaks are frequent, and control remains challenging in acute care and long-term healthcare settings. This review examines recent publications on the determinants of nosocomial influenza prevention and control. RECENT FINDINGS Nosocomial influenza outbreaks occur in various healthcare settings, especially among the frail and elderly. The correct diagnosis is commonly missed because a substantial proportion of asymptomatic cases can transmit infections. Rapid diagnosis will facilitate rapid identification of cases and the implementation of control measures but needs confirmation in some circumstances, such as the description of transmission chains. Links between patients and healthcare personnel (HCP) have been well explored by phylogenetic virus characterization and need additional refinement and study. The preventive role of HCP vaccination in influenza incidence among patients should be investigated further in various settings to take into account different strategies for vaccination (i.e. voluntary or mandatory vaccination policies). Indeed, in Europe, influenza vaccination remains modest, whereas in North America hospitals and some states and provinces are now mandating influenza vaccination among HCP. The variability of vaccine effectiveness by seasonal epidemics is also an important consideration for control strategies. SUMMARY When influenza cases occur in the community, the risk of transmission and nosocomial cases increase in healthcare settings requiring vigilance among staff. Surveillance and early warning systems should be encouraged. Outbreak control needs appropriate identification of cases and transmission chains, and rapid implementation of control measures. Vaccination policies in conjunction with appropriate infection control measures could reduce virus spreading in hospitals. HCP vaccination coverage must be improved.
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Sfeir M, Simon MS, Banach D. Isolation Precautions for Visitors to Healthcare Settings. INFECTION PREVENTION 2018. [PMCID: PMC7123668 DOI: 10.1007/978-3-319-60980-5_4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Visitors may be involved in infection transmission within healthcare settings; however, there is currently limited published data on this subject. This chapter describes situations in which visitor-associated infection transmission occurred and highlights the potential role of visitors in the transmission of pathogenic organisms that can lead to outbreaks in healthcare settings. Infection prevention measures, including isolation precautions and visitor restriction, may be utilized and potentially adapted in order to protect patients and their visitors as well as healthcare personnel. The practical and ethical challenges regarding the use of isolation precautions among visitors to healthcare facilities are discussed.
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Jorgensen P, Mereckiene J, Cotter S, Johansen K, Tsolova S, Brown C. How close are countries of the WHO European Region to achieving the goal of vaccinating 75% of key risk groups against influenza? Results from national surveys on seasonal influenza vaccination programmes, 2008/2009 to 2014/2015. Vaccine 2017; 36:442-452. [PMID: 29287683 PMCID: PMC5777640 DOI: 10.1016/j.vaccine.2017.12.019] [Citation(s) in RCA: 174] [Impact Index Per Article: 24.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 12/06/2017] [Accepted: 12/07/2017] [Indexed: 11/04/2022]
Abstract
Background Influenza vaccination is recommended especially for persons at risk of complications. In 2003, the World Health Assembly urged Member States (MS) to increase vaccination coverage to 75% among older persons by 2010. Objective To assess progress towards the 2010 vaccination goal and describe seasonal influenza vaccination recommendations in the World Health Organization (WHO) European Region. Methods Data on seasonal influenza vaccine recommendations, dose distribution, and target group coverage were obtained from two sources: European Union and European Economic Area MS data were extracted from influenza vaccination surveys covering seven seasons (2008/2009–2014/2015) published by the Vaccine European New Integrated Collaboration Effort and European Centre for Disease Prevention and Control. For the remaining WHO European MS, a separate survey on policies and uptake for all seasons (2008/2009–2014/2015) was distributed to national immunization programmes in 2015. Results Data was available from 49 of 53 MS. All but two had a national influenza vaccination policy. High-income countries distributed considerably higher number of vaccines per capita (median; 139.2 per 1000 population) compared to lower-middle-income countries (median; 6.1 per 1000 population). Most countries recommended vaccination for older persons, individuals with chronic disease, healthcare workers, and pregnant women. Children were included in < 50% of national policies. Only one country reached 75% coverage in older persons (2014/2015), while a number of countries reported declining vaccination uptake. Coverage of target groups was overall low, but with large variations between countries. Vaccination coverage was not monitored for several groups. Conclusions Despite policy recommendations, influenza vaccination uptake remains suboptimal. Low levels of vaccination is not only a missed opportunity for preventing influenza in vulnerable groups, but could negatively affect pandemic preparedness. Improved understanding of barriers to influenza vaccination is needed to increase uptake and reverse negative trends. Furthermore, implementation of vaccination coverage monitoring is critical for assessing performance and impact of the programmes.
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Affiliation(s)
- Pernille Jorgensen
- WHO Regional Office for Europe, UN City, Marmorvej 51, 2100 Copenhagen, Denmark.
| | - Jolita Mereckiene
- Health Protection Surveillance Centre, 25-27 Middle Gardiner Street, Dublin 1, Ireland
| | - Suzanne Cotter
- Health Protection Surveillance Centre, 25-27 Middle Gardiner Street, Dublin 1, Ireland
| | - Kari Johansen
- European Centre for Disease Prevention and Control, Tomtebodavägen 11A, 171 65 Solna, Sweden
| | - Svetla Tsolova
- European Centre for Disease Prevention and Control, Tomtebodavägen 11A, 171 65 Solna, Sweden
| | - Caroline Brown
- WHO Regional Office for Europe, UN City, Marmorvej 51, 2100 Copenhagen, Denmark
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Hagemeister MH, Stock NK, Ludwig T, Heuschmann P, Vogel U. Self-reported influenza vaccination rates and attitudes towards vaccination among health care workers: results of a survey in a German university hospital. Public Health 2017; 154:102-109. [PMID: 29220709 DOI: 10.1016/j.puhe.2017.10.027] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 09/12/2017] [Accepted: 10/26/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVES The objective of this survey was to analyse vaccination rates and attitudes towards vaccination among health care workers (HCWs). The period prevalence of self-reported acute respiratory infections in the influenza season 2014/2015 was examined. STUDY DESIGN A cross-sectional study was conducted among HCWs of a German university hospital using an anonymised questionnaire. Recruitment was performed by providing all medical and nursing staff a paper questionnaire with an invitation to participate. METHODS Descriptive aggregated data were generated from digitalised questionnaires for all variables. Differences in categorical variables were analysed by Chi-squared test. Textual data were analysed by an iterative process based on the grounded theory by Glaser and Strauss. RESULTS The response rate was 31% (677/2186). Probable influenza was described by 9% (64/677) of the participants. The overall self-reported vaccination rate was 55% (366/666). Self-reported vaccination rate was higher in physicians (172/239, 72%) than in nursing staff (188/418, 45%). HCWs in paediatrics (103/148, 70%) more likely received vaccines than HCWs in surgery (31/84, 37%). Most vaccinations were provided by medical staff on the wards (164/368, 45%). Self-reported lost work-time due to adverse events after vaccination was low (6/336, 2%). Eight categories for vaccine refusal were identified, whereof doubts about effectiveness and indication of the vaccine was most frequently mentioned (72/202, 36%). CONCLUSIONS Efforts to promote vaccination should focus on nursing staff and should provide scientific evidence on effectiveness, adverse effects, and the benefits of health care workers' vaccination for patients. Administering vaccines at the workplace proved to be a successful strategy in our setting. Studies are needed to assess the frequency of influenza causing disease in HCWs.
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Affiliation(s)
- M H Hagemeister
- Public Health Authority, District Office Kitzingen, Bavaria, Germany; Infection Control, University Hospital Würzburg, Bavaria, Germany.
| | - N K Stock
- Institute for Hygiene and Microbiology, University of Würzburg, Bavaria, Germany
| | - T Ludwig
- Institute for Clinical Epidemiology and Biometry, University of Würzburg, Bavaria, Germany
| | - P Heuschmann
- Institute for Clinical Epidemiology and Biometry, University of Würzburg, Bavaria, Germany; Clinical Trial Centre, University Hospital Würzburg, Bavaria, Germany
| | - U Vogel
- Infection Control, University Hospital Würzburg, Bavaria, Germany; Institute for Hygiene and Microbiology, University of Würzburg, Bavaria, Germany
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Preventing Respiratory Viral Transmission in Long-Term Care: Knowledge, Attitudes, and Practices of Healthcare Personnel. Infect Control Hosp Epidemiol 2017; 38:1449-1456. [DOI: 10.1017/ice.2017.232] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVETo examine knowledge and attitudes about influenza vaccination and infection prevention practices among healthcare personnel (HCP) in a long-term-care (LTC) setting.DESIGNKnowledge, attitudes, and practices (KAP) survey.SETTINGAn LTC facility in St Louis, Missouri.PARTICIPANTSAll HCP working at the LTC facility were eligible to participate, regardless of department or position. Of 170 full- and part-time HCP working at the facility, 73 completed the survey, a 42.9% response rate.RESULTSMost HCP agreed that respiratory viral infections were serious and that hand hygiene and face mask use were protective. However, only 46% could describe the correct transmission-based precautions for an influenza patient. Correctly answering infection prevention knowledge questions did not vary by years of experience but did vary for HCP with more direct patient contact versus less patient contact. Furthermore, 42% of respondents reported working while sick, and 56% reported that their coworkers did. In addition, 54% reported that facility policies made staying home while ill difficult. Some respondents expressed concerns about the safety (22%) and effectiveness (27%) of the influenza vaccine, and 28% of respondents stated that they would not get the influenza vaccine if it was not required.CONCLUSIONSThis survey of staff in an LTC facility identified several areas for policy improvement, particularly sick leave, as well as potential targets for interventions to improve infection prevention knowledge and to address HCP concerns about influenza vaccination to improve HCP vaccination rates in LTCs.Infect Control Hosp Epidemiol 2017;38:1449–1456
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Lim DW, Lee LT, Kyaw WM, Chow A. Psychosocial determinants of influenza vaccination intention: A cross-sectional study on inpatient nurses in Singapore. Am J Infect Control 2017; 45:e115-e117. [PMID: 28449916 PMCID: PMC7132738 DOI: 10.1016/j.ajic.2017.03.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Revised: 03/20/2017] [Accepted: 03/20/2017] [Indexed: 11/19/2022]
Abstract
Nurses have the closest interaction with inpatients and could transmit influenza to patients. From a self-administered questionnaire survey among inpatient nurses at a tertiary hospital, we observed that the strongest factors associated with intention for future vaccination were perceived benefits of and motivations for vaccination (adjusted odds ratio [aOR], 3.30; 95% confidence interval [CI], 2.55-4.27), and perceived nonsusceptibility to influenza and preference for vaccination alternatives (aOR, 0.26; 95% CI, 0.20-0.34). These factors need to be addressed to increase vaccination uptake and prevent nosocomial transmission.
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Affiliation(s)
- Dwee Wee Lim
- Department of Clinical Epidemiology, Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore, Singapore
| | - Lay Tin Lee
- Occupational Health Services, Tan Tock Seng Hospital, Singapore, Singapore
| | - Win Mar Kyaw
- Department of Clinical Epidemiology, Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore, Singapore
| | - Angela Chow
- Department of Clinical Epidemiology, Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore, Singapore.
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Mandatory influenza vaccination for all healthcare personnel: a review on justification, implementation and effectiveness. Curr Opin Pediatr 2017; 29:606-615. [PMID: 28700416 DOI: 10.1097/mop.0000000000000527] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW As healthcare-associated influenza is a serious public health concern, this review examines legal and ethical arguments supporting mandatory influenza vaccination policies for healthcare personnel, implementation issues and evidence of effectiveness. RECENT FINDINGS Spread of influenza from healthcare personnel to patients can result in severe harm or death. Although most healthcare personnel believe that they should be vaccinated against seasonal influenza, the Centers for Disease Control and Prevention (CDC) report that only 79% of personnel were vaccinated during the 2015-2016 season. Vaccination rates were as low as 44.9% in institutions that did not promote or offer the vaccine, compared with rates of more than 90% in institutions with mandatory vaccination policies. Policies that mandate influenza vaccination for healthcare personnel have legal and ethical justifications. Implementing such policies require multipronged approaches that include education efforts, easy access to vaccines, vaccine promotion, leadership support and consistent communication emphasizing patient safety. SUMMARY Mandatory influenza vaccination for healthcare personnel is a necessary step in protecting patients. Patients who interact with healthcare personnel are often at an elevated risk of complications from influenza. Vaccination is the best available strategy for protecting against influenza and evidence shows that institutional policies and state laws can effectively increase healthcare personnel vaccination rates, decreasing the risk of transmission in healthcare settings. There are legal and ethical precedents for institutional mandatory influenza policies and state laws, although successful implementation requires addressing both administrative and attitudinal barriers.
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Lansbury LE, Brown CS, Nguyen‐Van‐Tam JS. Influenza in long-term care facilities. Influenza Other Respir Viruses 2017; 11:356-366. [PMID: 28691237 PMCID: PMC5596516 DOI: 10.1111/irv.12464] [Citation(s) in RCA: 104] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2017] [Indexed: 01/13/2023] Open
Abstract
Long-term care facility environments and the vulnerability of their residents provide a setting conducive to the rapid spread of influenza virus and other respiratory pathogens. Infections may be introduced by staff, visitors or new or transferred residents, and outbreaks of influenza in such settings can have devastating consequences for individuals, as well as placing extra strain on health services. As the population ages over the coming decades, increased provision of such facilities seems likely. The need for robust infection prevention and control practices will therefore remain of paramount importance if the impact of outbreaks is to be minimised. In this review, we discuss the nature of the problem of influenza in long-term care facilities, and approaches to preventive and control measures, including vaccination of residents and staff, and the use of antiviral drugs for treatment and prophylaxis, based on currently available evidence.
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Affiliation(s)
- Louise E. Lansbury
- Health Protection and Influenza Research GroupDivision of Epidemiology and Public HealthCity HospitalUniversity of NottinghamNottinghamUK
| | - Caroline S. Brown
- Influenza & Other Respiratory Pathogens ProgrammeDivision of Communicable Diseases and Health SecurityWHO Regional Office for EuropeUN CityCopenhagenDenmark
| | - Jonathan S. Nguyen‐Van‐Tam
- Health Protection and Influenza Research GroupDivision of Epidemiology and Public HealthCity HospitalUniversity of NottinghamNottinghamUK
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Shahar I, Mendelson G, Ben Natan M. Intention to receive the seasonal influenza vaccine among nurses working in a long-term care facility. Int J Nurs Pract 2017; 23. [PMID: 28112461 DOI: 10.1111/ijn.12512] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 10/24/2016] [Accepted: 11/18/2016] [Indexed: 11/30/2022]
Abstract
The factors affecting influenza vaccine uptake among nurses might vary between different medical facilities. The purpose of the present study was to explore factors that affect the intention of nurses at a long-term care facility to receive the influenza vaccine and whether the health belief model predicts this intention. In this cross-sectional quantitative correlational study, a convenience sample of 150 nurses employed at a large long-term care facility in central Israel completed a questionnaire based on the health belief model. Data collection took place between January and February of 2016. Forty-two percent of the respondents reported having been vaccinated against influenza in the current year. The health belief model explained 53% of the variance (p < .01), with perceived (personal) benefits of the vaccine being the most significant factor. The number of times of receiving the influenza vaccine in the past was strongly correlated with the intention to receive the vaccine (p < .01). To improve nurses' compliance with influenza vaccination at long-term care facilities, we find that it is necessary to emphasize the benefits of vaccination and, particularly, the personal benefits. Annual vaccination behavior should be promoted to make it become a routine.
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Affiliation(s)
| | | | - Merav Ben Natan
- Pat Matthews Academic School of Nursing, Hillel Yaffe Medical Center, Hadera, Israel
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Gonçalves AR, Iten A, Suter‐Boquete P, Schibler M, Kaiser L, Cordey S. Hospital surveillance of influenza strains: a concordant image of viruses identified by the Swiss Sentinel system? Influenza Other Respir Viruses 2017; 11:41-47. [PMID: 27441401 PMCID: PMC5155643 DOI: 10.1111/irv.12417] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2016] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The Swiss Sentinel system for influenza virus surveillance reports influenza-like illness in the community through a network of primary care practitioners, but the epidemiologic, demographic, and virological characterization may differ from that observed in hospitalized patients with influenza. OBJECTIVE To compare demographic and virological data from hospital influenza cases with Sentinel system data during the 2014-2015 season. METHODS We included 2623 in- and outpatients with a screening request for influenza A/B in a university teaching hospital in Geneva, Switzerland, and 933 participants from the Swiss Sentinel surveillance system and compared the demographic and virological data of the two populations, including the respective distribution of influenza subtypes, and conducted a phylogenetic comparison at the HA1 level of influenza viruses recovered in community and hospital cases. RESULTS There were similar proportions of influenza strains recovered in the hospital and in the community (H3N2, 57.1% and 56.9%; H1N1pdm09, 15.5% and 14.2%; B, 27.4% and 28.8%, respectively). HA1 sequence analysis confirmed that all three strains were genetically similar between the two populations. During this particular season, influenza cases were detected earlier in the hospital than in the Sentinel system. CONCLUSIONS Although an influenza surveillance system based on the community can predict the type of influenza strains that will be associated with hospitalizations, it fails to estimate the potential virulence of circulating strains. Further, the population characteristics in the community differ from those in hospitalized patients. This suggests that any national influenza surveillance system should include both community- and hospital-based surveys.
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MESH Headings
- Adolescent
- Adult
- Aged
- Child
- Child, Preschool
- Community Health Services
- Female
- Hemagglutinin Glycoproteins, Influenza Virus/genetics
- Hospitalization
- Humans
- Infant
- Infant, Newborn
- Influenza A Virus, H1N1 Subtype/classification
- Influenza A Virus, H1N1 Subtype/genetics
- Influenza A Virus, H1N1 Subtype/isolation & purification
- Influenza A Virus, H3N2 Subtype/classification
- Influenza A Virus, H3N2 Subtype/genetics
- Influenza A Virus, H3N2 Subtype/isolation & purification
- Influenza B virus/genetics
- Influenza B virus/isolation & purification
- Influenza, Human/epidemiology
- Influenza, Human/virology
- Male
- Middle Aged
- Phylogeny
- Seasons
- Sentinel Surveillance
- Switzerland/epidemiology
- Young Adult
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Affiliation(s)
- Ana Rita Gonçalves
- Swiss National Reference Centre for InfluenzaGeneva University HospitalsGenevaSwitzerland
- Laboratory of VirologyGeneva University HospitalsGenevaSwitzerland
- University of Geneva Medical SchoolGenevaSwitzerland
| | - Anne Iten
- University of Geneva Medical SchoolGenevaSwitzerland
- Infection Control Program and WHO Collaborating Centre on Patient SafetyGeneva University HospitalsGenevaSwitzerland
| | - Patricia Suter‐Boquete
- Swiss National Reference Centre for InfluenzaGeneva University HospitalsGenevaSwitzerland
- Laboratory of VirologyGeneva University HospitalsGenevaSwitzerland
- University of Geneva Medical SchoolGenevaSwitzerland
| | - Manuel Schibler
- Laboratory of VirologyGeneva University HospitalsGenevaSwitzerland
- University of Geneva Medical SchoolGenevaSwitzerland
| | - Laurent Kaiser
- Swiss National Reference Centre for InfluenzaGeneva University HospitalsGenevaSwitzerland
- Laboratory of VirologyGeneva University HospitalsGenevaSwitzerland
- University of Geneva Medical SchoolGenevaSwitzerland
| | - Samuel Cordey
- Swiss National Reference Centre for InfluenzaGeneva University HospitalsGenevaSwitzerland
- Laboratory of VirologyGeneva University HospitalsGenevaSwitzerland
- University of Geneva Medical SchoolGenevaSwitzerland
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Contal E, Putot A, Dipanda M, Perrin S, Asgassou S, Sordet-Guépet H, Manckoundia P. [The seasonal flu vaccination among caregivers in geriatric units: Up-to-date]. Rev Epidemiol Sante Publique 2016; 64:415-423. [PMID: 27816309 DOI: 10.1016/j.respe.2016.06.333] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 06/03/2016] [Accepted: 06/27/2016] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Flu vaccinations for healthcare professionals seems to be one of the most effective preventive actions in the face of a disease that carries a high risk of a potentially serious nosocomial epidemic in a geriatric environment. The aim of this study was to take stock of the flu vaccination status among caregivers in the geriatric units and to understand the reasons for their reluctance to be vaccinated, in order to put forward proposals to improve vaccination coverage. METHOD A literature search of articles published since 2000 in the area of geriatrics, infectious diseases or pneumology was mainly conducted on PubMed using the keywords "caregivers", "elderly", "flu", "influenza", "nosocomial" and "vaccination". After reading all abstracts in English or French and ruling out irrelevant articles, only 64 relevant articles have been listed in bibliography section. RESULTS Despite official recommendations, the literature reveals insufficient vaccination coverage of healthcare personnel at both the national and international level. Vaccination coverage seems to be lower among younger female non-medical staff. The factors that determine the likelihood of vaccination are the wish to protect one's self, one's family and patients/residents, as well as the experience of earlier bouts of flu. Factors that oppose vaccination are complex and related to the fear of side effects, the use of other preventive measures, the feeling that vaccination is ineffective, poor understanding of the disease and the vaccine, forgetfulness and problems of organization. Campaigns to promote vaccination that target healthcare professionals must be multidimensional and very incentive. The pedagogical message must be centered on the benefits to the individual and adjusted to socio-professional categories. Mobile strategies in the different departments to encourage staff are a pragmatic solution to this challenge. The referring doctor has an essential role to play, as does the occupational doctor in association with the hospital hygiene services. CONCLUSION Flu vaccinations must be included in the education and training of caregivers.
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Affiliation(s)
- E Contal
- Service de médecine A, centre hospitalier de Langres, 10, rue de la Charité, 52200 Langres, France
| | - A Putot
- Service de médecine interne gériatrie, hôpital de Champmaillot, CHU, BP 87909, 2, rue Jules-Violle, 21079 Dijon cedex, France
| | - M Dipanda
- Service de médecine interne gériatrie, hôpital de Champmaillot, CHU, BP 87909, 2, rue Jules-Violle, 21079 Dijon cedex, France
| | - S Perrin
- Service de médecine interne gériatrie, hôpital de Champmaillot, CHU, BP 87909, 2, rue Jules-Violle, 21079 Dijon cedex, France
| | - S Asgassou
- Service de médecine interne gériatrie, hôpital de Champmaillot, CHU, BP 87909, 2, rue Jules-Violle, 21079 Dijon cedex, France
| | - H Sordet-Guépet
- Service de médecine interne gériatrie, hôpital de Champmaillot, CHU, BP 87909, 2, rue Jules-Violle, 21079 Dijon cedex, France
| | - P Manckoundia
- Service de médecine interne gériatrie, hôpital de Champmaillot, CHU, BP 87909, 2, rue Jules-Violle, 21079 Dijon cedex, France; Inserm U1093 cognition, action, et plasticité sensorimotrice, université de Bourgogne-Franche-Comté, UFR STAPS, 21078 Dijon, France.
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Masse S, Minodier L, Heuze G, Blanchon T, Capai L, Falchi A. Influenza-like illness outbreaks in nursing homes in Corsica, France, 2014-2015: epidemiological and molecular characterization. SPRINGERPLUS 2016; 5:1338. [PMID: 27563533 PMCID: PMC4981007 DOI: 10.1186/s40064-016-2957-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 07/29/2016] [Indexed: 11/25/2022]
Abstract
Background To study the molecular epidemiology of the influenza outbreaks in nursing homes (NHs) to determine whether multiple influenza strains were involved. Methods From September to December 2014, NHs in Corsica were invited to participate in an ongoing daily epidemiological and microbiological surveillance for influenza-like illness (ILI) among residents and health care workers (HCWs). Results The study involved 12 NHs. Respiratory illness meeting the ILI case definition was observed among 44 residents from whom 22 specimens were collected. Of the 22 residents with a nasopharyngeal sample, 13 (59 %) were positive for at least one of the 11 pathogens analysed. Among these 13 patients, 11 (92 %) presented a confirmed influenza (A/H3N2) and two had another respiratory virus: one human metapneumovirus and one human coronavirus. Of patients with a confirmed influenza A(H3N2), 10 (91 %) were vaccinated against influenza during the 2014–2015 season. Two influenza outbreaks were reported in two NHs, caused by influenza A(H3N2) strains belonging to cluster 3C.3 and 3C.2a. Although antivirals were available, prophylaxis was not used. Conclusions Phylogenetic analysis seems to suggest no multiple introduction into the two NHs reporting the two influenza A(H3N2) outbreaks. A number of factors could have contributed to transmitting influenza in NHs including, the absence of administration of antiviral treatment for prophylaxis of all residents/staff regardless of immunization status because of the poor vaccine match during each outbreak, the intensive contacts with incompletely protected residents and HCWs, and the low adherence of NHs to notification of ILI outbreaks to the health authorities. Electronic supplementary material The online version of this article (doi:10.1186/s40064-016-2957-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- S Masse
- EA 7310, Laboratory of Virology, University of Corsica-Inserm, Corte, France
| | - L Minodier
- EA 7310, Laboratory of Virology, University of Corsica-Inserm, Corte, France
| | - G Heuze
- CIRE-SUD Paca Corse, InVS, Saint-Maurice Cedex, Paris, France
| | - T Blanchon
- UPMC Univ Paris 06, UMR_S 1136, Sorbonne Universités, Paris, France ; INSERM, UMR_S 1136, Paris, France
| | - L Capai
- EA 7310, Laboratory of Virology, University of Corsica-Inserm, Corte, France ; UPMC Univ Paris 06, UMR_S 1136, Sorbonne Universités, Paris, France ; INSERM, UMR_S 1136, Paris, France
| | - A Falchi
- EA 7310, Laboratory of Virology, University of Corsica-Inserm, Corte, France
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Haviari S, Bénet T, Saadatian-Elahi M, André P, Loulergue P, Vanhems P. Vaccination of healthcare workers: A review. Hum Vaccin Immunother 2016; 11:2522-37. [PMID: 26291642 DOI: 10.1080/21645515.2015.1082014] [Citation(s) in RCA: 113] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Vaccine-preventable diseases are a significant cause of morbidity and mortality. As new vaccines are proving to be effective and as the incidence of some infections decreases, vaccination practices are changing. Healthcare workers (HCWs) are particularly exposed to and play a role in nosocomial transmission, which makes them an important target group for vaccination. Most vaccine-preventable diseases still carry a significant risk of resurgence and have caused outbreaks in recent years. While many professional societies favor vaccination of HCWs as well as the general population, recommendations differ from country to country. In turn, vaccination coverage varies widely for each microorganism and for each country, making hospitals and clinics vulnerable to outbreaks. Vaccine mandates and non-mandatory strategies are the subject of ongoing research and controversies. Optimal approaches to increase coverage and turn the healthcare workforce into an efficient barrier against infectious diseases are still being debated.
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Affiliation(s)
- Skerdi Haviari
- a Service d'Hygiène, Epidémiologie et Prévention, Hôpital Edouard Herriot, Hospices Civils de Lyon ; Lyon , France
| | - Thomas Bénet
- a Service d'Hygiène, Epidémiologie et Prévention, Hôpital Edouard Herriot, Hospices Civils de Lyon ; Lyon , France.,b Equipe Epidémiologie et Santé Publique, Université de Lyon, Université Lyon 1 ; Lyon , France.,c Institut National de la Santé et de la Recherche Médicale (INSERM), French Clinical Research Investigation Network (F-CRIN), Innovative Clinical Research Network in Vaccinology (I-REIVAC) ; Lyon , France
| | - Mitra Saadatian-Elahi
- a Service d'Hygiène, Epidémiologie et Prévention, Hôpital Edouard Herriot, Hospices Civils de Lyon ; Lyon , France
| | - Philippe André
- a Service d'Hygiène, Epidémiologie et Prévention, Hôpital Edouard Herriot, Hospices Civils de Lyon ; Lyon , France
| | - Pierre Loulergue
- c Institut National de la Santé et de la Recherche Médicale (INSERM), French Clinical Research Investigation Network (F-CRIN), Innovative Clinical Research Network in Vaccinology (I-REIVAC) ; Lyon , France.,d Université Paris Descartes, Sorbonne Paris Cité, INSERM, CIC 1417, Assistance Publique Hôpitaux de Paris (AP-HP), Groupe Hospitalier Cochin Broca Hôtel Dieu, CIC Cochin-Pasteur ; Paris , France.,e INSERM, F-CRIN, I-REIVAC, Cochin Center ; Paris , France
| | - Philippe Vanhems
- a Service d'Hygiène, Epidémiologie et Prévention, Hôpital Edouard Herriot, Hospices Civils de Lyon ; Lyon , France.,b Equipe Epidémiologie et Santé Publique, Université de Lyon, Université Lyon 1 ; Lyon , France.,c Institut National de la Santé et de la Recherche Médicale (INSERM), French Clinical Research Investigation Network (F-CRIN), Innovative Clinical Research Network in Vaccinology (I-REIVAC) ; Lyon , France
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Buchan SA, Kwong JC. Influenza immunization among Canadian health care personnel: a cross-sectional study. CMAJ Open 2016; 4:E479-E488. [PMID: 27730112 PMCID: PMC5047845 DOI: 10.9778/cmajo.20160018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Influenza immunization coverage among Canadian health care personnel remains below national targets. Targeting this group is of particular importance given their elevated risk of influenza infection, role in transmission and influence on patients' immunization status. We examined influenza immunization coverage in health care personnel in Canada, reasons for not being immunized and the impact of "vaccinate-or-mask" influenza prevention policies. METHODS In this national cross-sectional study, we pooled data from the 2007 to 2014 cycles of the Canadian Community Health Survey and restricted it to respondents who reported a health care occupation. Using bootstrapped survey weights, we examined immunization coverage by occupation and by presence of vaccinate-or-mask policies, and reasons for not being immunized. We used modified Poisson regression to estimate the prevalence ratio (PR) of influenza immunization for health care occupations compared with the general working population. RESULTS For all survey cycles combined, 50% of 18 446 health care personnel reported receiving seasonal influenza immunization during the previous 12 months, although this varied by occupation type (range 4%-72%). Compared with the general working population, family physicians and general practitioners were most likely to be immunized (PR 3.15, 95% confidence interval [CI] 2.76-3.59), whereas chiropractors, midwives and practitioners of natural healing were least likely (PR 0.17, 95% CI 0.10-0.30). Among those who were not immunized, the most frequently cited reason was the belief that influenza immunization is unnecessary. Introduction of vaccinate-or-mask policies was associated with increased influenza immunization among health care personnel. INTERPRETATION Health care personnel are more likely to be immunized against influenza than the general working population, but coverage remains suboptimal overall, and we observed wide variation by occupation type. More efforts are needed to target specific health care occupations with low immunization coverage.
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Affiliation(s)
- Sarah A Buchan
- Dalla Lana School of Public Health (Buchan, Kwong), University of Toronto; Department of Family and Community Medicine (Kwong), University of Toronto; Institute for Clinical Evaluative Sciences (Kwong), Toronto, Ont
| | - Jeffrey C Kwong
- Dalla Lana School of Public Health (Buchan, Kwong), University of Toronto; Department of Family and Community Medicine (Kwong), University of Toronto; Institute for Clinical Evaluative Sciences (Kwong), Toronto, Ont
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50
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Management of an influenza A outbreak on an acute internal medicine ward. J Hosp Infect 2016; 94:154-5. [PMID: 27344530 DOI: 10.1016/j.jhin.2016.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 06/08/2016] [Indexed: 11/21/2022]
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